ArticleHealthcare (Basel, Switzerland)2021
Exploring Barriers and Facilitators of Adherence to Artemisinin-Based Combination Therapies for the Treatment of Uncomplicated Malaria in Children in Freetown, Sierra Leone.
Article in Healthcare (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Facilitators and barriers to adherence to severe malaria treatment guidelines in children at Mbale Regional Referral Hospital, Uganda: a health workers' perspective.Malaria journal · 2026Article
- Understanding barriers to effective malaria diagnosis and treatment: A mixed-methods study in Uganda, Nigeria, and Ivory Coast.PLOS global public health · 2026Article
- Navigating the Parasitic Landscape: Insights into Infection Patterns and Public Health Strategies in West Africa.Tropical medicine and infectious disease · 2025Review
- Adapting malaria indicator surveys to investigate treatment adherence: a pilot study on Bioko Island, Equatorial Guinea.Malaria journal · 2024Article
- Barriers to accessing malaria treatment amongst school-age children in rural Malawi.Malaria journal · 2023Article
- Responsive Sensory Evaluation to Develop Flexible Taste-Masked Paediatric Primaquine Tablets against Malaria for Low-Resource Settings.Pharmaceutics · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Medication adherence is an essential step in the malaria treatment cascade. We conducted a qualitative study embedded within a randomized controlled trial comparing the adherence to the recommended dosing of two artemisinin-based combination therapies (ACT) to treat uncomplicated malaria in Freetown, Sierra Leone. This study explored the circumstances and factors that influenced caregiver adherence to the ACT prescribed for their child in the trial. In-depth interviews were conducted with 49 caregivers; all interviews were recorded, transcribed, and translated. Transcripts were coded and aggregated into themes, applying a thematic content approach. We identified four key factors that influenced optimal treatment adherence: (1) health system influences, (2) health services, (3) caregivers' experiences with malaria illness and treatment, and (4) medication characteristics. Specifically, caregivers reported confidence in the health system as facilities were well maintained and care was free. They also felt that health workers provided quality care, leading them to trust the health workers and believe the test results. Ease of medication administration and perceived risk of side effects coupled with caregivers' prior experience treating malaria influenced how medications were administered. To ensure ACTs achieve maximum effectiveness, consideration of these contextual factors and further development of child-friendly antimalarials are needed.
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Registered trials
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