The difference between effectiveness and efficacy of antimalarial drugs in Kenya
To demonstrate the difference between effectiveness and efficacy of antimalarial (AM) drugs in Kenya. Methods
We undertook a series of linked surveys in four districts of Kenya between 2001 and 2002 on (i) community usage of nationally recommended first- and second-line AM drugs; (ii) commonly stocked AM products in the retail and wholesale sectors; and (iii) quality of the most commonly available first- and second-line AM products. These were combined with estimates of adherence and clinical efficacy to derive overall drug effectiveness. Results
The overall modelled effectiveness for sulphadoxine–pyrimethamine (SP) was estimated to be 62% compared with 85% for reported SP clinical efficacy. For amodiaquine the modelled effectiveness was 48% compared with 99% reported efficacy during the same time period. Conclusions
The quality of AM products and patient adherence to dosage regimens are important determinants of drug effectiveness, and should be measured alongside clinical efficacy. Post-registration measures to regulate drug quality and improve patient adherence would contribute significantly to AM drug performance.
Document Type: Research Article
Affiliations: 1: Kenya Medical Research Institute/Wellcome Trust Collaborative Programme, Nairobi, Kenya 2: Department of Pharmacology and Therapeutics, Liverpool University, Liverpool, UK 3: Kenya Medical Research Institute/Centre for Geographic Medicine Coast Research, Kilifi, Kenya 4: Division of Malaria Control, Ministry of Health, Nairobi, Kenya
Publication date: 2004-09-01