The Malaria Testing and Treatment Market in Kinshasa, Democratic Republic of the Congo, 2013

Background The Democratic Republic of Congo (DRC) is one of the two most leading contributors to the global burden of disease due to malaria. This paper describes the malaria testing and treatment market in the nation’s capital province of Kinshasa, including availability of malaria testing and treatment and relative anti-malarial market share for the public and private sector. Methods A malaria medicine outlet survey was conducted in Kinshasa province in 2013. Stratified multi-staged sampling was used to select areas for the survey. Within sampled areas, all outlets with the potential to sell or distribute anti-malarials in the public and private sector were screened for eligibility. Among outlets with anti-malarials or malaria rapid diagnostic tests (RDT) in stock, a full audit of all available products was conducted. Information collected included product information (e.g. active ingredients, brand name), amount reportedly distributed to patients in the past week, and retail price. Results In total, 3364 outlets were screened for inclusion across Kinshasa and 1118 outlets were eligible for the study. Among all screened outlets in the private sector only about one in ten (12.1%) were stocking quality-assured Artemisinin-based Combination Therapy (ACT) medicines. Among all screened public sector facilities, 24.5% had both confirmatory testing and quality-assured ACT available, and 20.2% had sulfadoxine-pyrimethamine (SP) available for intermittent preventive therapy during pregnancy (IPTp). The private sector distributed the majority of anti-malarials in Kinshasa (96.7%), typically through drug stores (89.1% of the total anti-malarial market). Non-artemisinin therapies were the most commonly distributed anti-malarial (50.1% of the total market), followed by non quality-assured ACT medicines (38.5%). The median price of an adult quality-assured ACT was $6.59, and more expensive than non quality-assured ACT ($3.71) and SP ($0.44). Confirmatory testing was largely not available in the private sector (1.1%). Conclusions While the vast majority of anti-malarial medicines distributed to patients in Kinshasa province are sold within the private sector, availability of malaria testing and appropriate treatment for malaria is alarmingly low. There is a critical need to improve access to confirmatory testing and quality-assured ACT in the private sector. Widespread availability and distribution of non quality-assured ACT and non-artemisinin therapies must be addressed to ensure effective malaria case management

Benin (2008): ACT Watch Outlet Survey (Baseline)

The objective of this study is to monitor levels and trends in the availability, price and volumes of antimalarials, and providers' perceptions and knowledge of antimalarial medicines at different outlets. An outlet is defined as any point of sale or provision of commodities for individuals. Outlets included in the survey are public health facilities, Part One pharmacies, private health facilities, and other outlets. A nationally representative sample of all outlets that could sell or provide antimalarials to a consumer was taken through a census approach in 19 sub-districts in Benin. Sampling was conducted using a one-stage probability proportional to size (PPS) cluster design, with the measure of size being the relative sub-district population. Outlet inclusion criteria for this study included outlets which stocked an antimalarial at the time of survey or in the previous three months. Three questionnaires were administered to collect information on the outlets and on the antimalarials that each had available

Benin (2009): ACT Watch 2009 Household Survey

Cette enquete est une partie du cadre de recherche ACTwatch, dont l'objectif est de controler le comportement des consommateurs, y compris leur choix des medicaments anti-paludisme et le coute de traitement. Les donnees des menages sont aussi utilisees pour identifier les determinants du comportement. L'etude transversale a interviewe 885 personnes ayant charge d'un enfant moins de 5 ans qui ont eu la fievre au cours des deux semaines precedants l'etude. Les enquetes ont lieu pendant la saison des pluies. L'enquete a compris deux questionnaires sur le comportement du gardien pendant l'incident de fievre