Factors associated with access and adherence to artemisinin-based combination therapy (ACT) for children under five: a secondary analysis of a national survey in Sierra Leone.

摘要: Access and adherence to artemisinin-based combination therapy (ACT) are key challenges effective malaria treatment. A secondary analysis of the Sierra Leone Knowledge, Attitudes, Practices (mKAP) survey was conducted investigate access ACT for treatment fever in children under-five. The mKAP a nationally representative, two-stage cluster-sample survey, 2012. Thirty primary sampling units per district were randomly selected using probability proportionate size, based on national census estimates; 14 households subsequently enrolled unit. restricted under-five with past two weeks. Factors associated assessed multivariate logistic regression. Of 5169 households, 1456 reported at least one child 1641 from these 982 (59.8%) received any analysed ACT; 469 (47.6%) 466 adherence. Only 222 (47.4%) febrile completed 3-day In an adjusted analysis, factors included knowledge (odds ratio [OR] 2.78, 95% CI 2.02–3.80; p < 0.001), insecticide-treated nets (ITNs) (OR 1.84, 1.29–2.63; p = 0.001), source care (public health facility vs. other; OR 1.86, 1.27–2.72, geographic region (East West; 2.30, 1.20–4.44; p = 0.025), age (24–59 0–23 months; 1.45, 1.07–1.96; p = 0.016). only factor time treatment; treated within 24 h less likely adhere 0.55, 0.34–0.89; p = 0.015). 2012, remained low Leone. Knowledge ITNs, seeking public sector, most strongly access. National surveys provide important information anti-malarial could be expanded measure