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The magnitude and trend of artemether-lumefantrine stock-outs at public health facilities in Kenya.

Sudoi RK, Githinji S, Nyandigisi A, Muturi A, Snow RW, Zurovac D - Malar. J. (2012)

Bottom Line: Monthly decrease of the total AL stock-out was 0.005% (95% CI: -0.5 to +0.5; p = 0.983).Despite lower levels of AL stock-outs compared to the reports in 2008, the stock-outs at Kenyan facilities during 2010-2011 are still substantial and of particular worry for the most detrimental:- simultaneous absence of any AL pack.Only minor decrease was observed in the stock-outs of individual AL packs.

View Article: PubMed Central - HTML - PubMed

Affiliation: Malaria Public Health and Epidemiology Group, KEMRI/Wellcome Trust Research Programme, PO Box 43640, 00100 GPO Nairobi, Kenya.

ABSTRACT

Background: Health facility stock-outs of artemether-lumefantrine (AL), the common first-line therapy for uncomplicated malaria across Africa, adversely affect effective malaria case-management. They have been previously reported on various scales in time and space, however the magnitude of the problem and trends over time are less clear. Here, 2010-2011 data are reported from public facilities in Kenya where alarming stock-outs were revealed in 2008.

Methods: Data were collected between January 2010 and June 2011 as part of 18 monthly cross-sectional surveys undertaken at nationally representative samples of public health facilities. The primary monitoring indicator was total stock-out of all four weight-specific AL packs. The secondary indicators were stock-outs of at least one AL pack and individual stock-outs for each AL pack. Monthly proportions and summary means of the proportions over the monitoring period were measured for each indicator. Stock-out trends were assessed using linear regression.

Results: The number of surveyed facilities across 18 time points ranged between 162 and 176 facilities. The stock-out means of the proportion of health facilities were 11.6% for total AL stock-out, 40.6% for stock-out of at least one AL pack, and between 20.5% and 27.4% for stock-outs of individual AL packs. Monthly decrease of the total AL stock-out was 0.005% (95% CI: -0.5 to +0.5; p = 0.983). Monthly decrease in the stock-out of at least one AL pack was 0.7% (95% CI: -1.5 to +0.3; p = 0.058) while stock-outs of individual AL packs decreased monthly between 0.2% for AL 24-pack and 0.7% for AL six-pack without statistical significance for any of the weight-specific packs.

Conclusions: Despite lower levels of AL stock-outs compared to the reports in 2008, the stock-outs at Kenyan facilities during 2010-2011 are still substantial and of particular worry for the most detrimental:- simultaneous absence of any AL pack. Only minor decrease was observed in the stock-outs of individual AL packs. Recently launched interventions to eliminate AL stock-outs in Kenya are fully justified.

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Related in: MedlinePlus

AL stock-out at Kenyan facilities between January 2010 and June 2011 (red bars showing total AL stock-out, blue bars showing stock-out of at least one AL pack, and red and blue lines showing trends over time for respective stock-out indicators).
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Figure 1: AL stock-out at Kenyan facilities between January 2010 and June 2011 (red bars showing total AL stock-out, blue bars showing stock-out of at least one AL pack, and red and blue lines showing trends over time for respective stock-out indicators).

Mentions: The number of surveyed facilities across 18 time points ranged between 162 and 176 facilities. Figure 1 shows monthly proportions and trends in stock-outs of at least one AL pack and simultaneous stock-out of all four AL packs (total AL stock-out). Mean of the proportion of health facilities with total AL stock-out across the study period was 11.6% (median 11.5%; monthly range: 3-20%) while mean stock-out of at least one AL pack was substantially higher -40.6% (median 38.0%; monthly range: 28-59%). AL stock-outs had shown a fluctuating pattern however overall changes in AL stock-outs during the monitoring period were minor. Over an 18-month period, monthly decrease of total AL stock was 0.005% (95% CI: -0.5 to +0.5; p = 0.983) while monthly decrease in the stock-out of at least one AL pack was 0.7% (95% CI: -1.5 to +0.3; p = 0.058).


The magnitude and trend of artemether-lumefantrine stock-outs at public health facilities in Kenya.

Sudoi RK, Githinji S, Nyandigisi A, Muturi A, Snow RW, Zurovac D - Malar. J. (2012)

AL stock-out at Kenyan facilities between January 2010 and June 2011 (red bars showing total AL stock-out, blue bars showing stock-out of at least one AL pack, and red and blue lines showing trends over time for respective stock-out indicators).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3306750&req=5

Figure 1: AL stock-out at Kenyan facilities between January 2010 and June 2011 (red bars showing total AL stock-out, blue bars showing stock-out of at least one AL pack, and red and blue lines showing trends over time for respective stock-out indicators).
Mentions: The number of surveyed facilities across 18 time points ranged between 162 and 176 facilities. Figure 1 shows monthly proportions and trends in stock-outs of at least one AL pack and simultaneous stock-out of all four AL packs (total AL stock-out). Mean of the proportion of health facilities with total AL stock-out across the study period was 11.6% (median 11.5%; monthly range: 3-20%) while mean stock-out of at least one AL pack was substantially higher -40.6% (median 38.0%; monthly range: 28-59%). AL stock-outs had shown a fluctuating pattern however overall changes in AL stock-outs during the monitoring period were minor. Over an 18-month period, monthly decrease of total AL stock was 0.005% (95% CI: -0.5 to +0.5; p = 0.983) while monthly decrease in the stock-out of at least one AL pack was 0.7% (95% CI: -1.5 to +0.3; p = 0.058).

Bottom Line: Monthly decrease of the total AL stock-out was 0.005% (95% CI: -0.5 to +0.5; p = 0.983).Despite lower levels of AL stock-outs compared to the reports in 2008, the stock-outs at Kenyan facilities during 2010-2011 are still substantial and of particular worry for the most detrimental:- simultaneous absence of any AL pack.Only minor decrease was observed in the stock-outs of individual AL packs.

View Article: PubMed Central - HTML - PubMed

Affiliation: Malaria Public Health and Epidemiology Group, KEMRI/Wellcome Trust Research Programme, PO Box 43640, 00100 GPO Nairobi, Kenya.

ABSTRACT

Background: Health facility stock-outs of artemether-lumefantrine (AL), the common first-line therapy for uncomplicated malaria across Africa, adversely affect effective malaria case-management. They have been previously reported on various scales in time and space, however the magnitude of the problem and trends over time are less clear. Here, 2010-2011 data are reported from public facilities in Kenya where alarming stock-outs were revealed in 2008.

Methods: Data were collected between January 2010 and June 2011 as part of 18 monthly cross-sectional surveys undertaken at nationally representative samples of public health facilities. The primary monitoring indicator was total stock-out of all four weight-specific AL packs. The secondary indicators were stock-outs of at least one AL pack and individual stock-outs for each AL pack. Monthly proportions and summary means of the proportions over the monitoring period were measured for each indicator. Stock-out trends were assessed using linear regression.

Results: The number of surveyed facilities across 18 time points ranged between 162 and 176 facilities. The stock-out means of the proportion of health facilities were 11.6% for total AL stock-out, 40.6% for stock-out of at least one AL pack, and between 20.5% and 27.4% for stock-outs of individual AL packs. Monthly decrease of the total AL stock-out was 0.005% (95% CI: -0.5 to +0.5; p = 0.983). Monthly decrease in the stock-out of at least one AL pack was 0.7% (95% CI: -1.5 to +0.3; p = 0.058) while stock-outs of individual AL packs decreased monthly between 0.2% for AL 24-pack and 0.7% for AL six-pack without statistical significance for any of the weight-specific packs.

Conclusions: Despite lower levels of AL stock-outs compared to the reports in 2008, the stock-outs at Kenyan facilities during 2010-2011 are still substantial and of particular worry for the most detrimental:- simultaneous absence of any AL pack. Only minor decrease was observed in the stock-outs of individual AL packs. Recently launched interventions to eliminate AL stock-outs in Kenya are fully justified.

Show MeSH
Related in: MedlinePlus