Feasibility of Distributing Rapid Diagnostic Tests for Malaria in the Retail Sector Evidence from an Implementation Study in Uganda 英文参考文献.docVIP

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Feasibility of Distributing Rapid Diagnostic Tests for Malaria in the Retail Sector Evidence from an Implementation Study in Uganda 英文参考文献.doc

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Feasibility of Distributing Rapid Diagnostic Tests for Malaria in the Retail Sector Evidence from an Implementation Study in Uganda 英文参考文献

FeasibilityofDistributingRapidDiagnosticTestsfor MalariaintheRetailSector:Evidencefroman ImplementationStudyinUganda JessicaCohen1,3*,Gu¨ntherFink1,KatrinaBerg4,FlaviaAber5,MatthewJordan3,KathleenMaloney5, WilliamDickens2,3 1HarvardSchool ofPublicHealth, HarvardUniversity,Boston, Massachusetts, United States ofAmerica, 2DepartmentofEconomics,NortheasternUniversity,Boston, Massachusetts,UnitedStatesofAmerica,3EconomicStudies,BrookingsInstitution,Washington,D.C.,UnitedStatesofAmerica,4JohnsHopkinsSchoolofPublicHealth, JohnsHopkinsUniversity,Baltimore,Maryland,UnitedStatesofAmerica,5ClintonHealthAccessInitiative,Kampala,Uganda Abstract Background:Despitethebenefitsofmalariadiagnosis,mostpresumedmalariaepisodesarenevertested.Aprimaryreason is the absence of diagnostic tests in retail establishments, where manypatients seek care. Malaria rapid diagnostic tests (RDTs)indrugshopsholdpromiseforguidingappropriatetreatment.However,retailprovidersgenerallylackawarenessof RDTs and training to administer them. Further, unsubsidized RDTs may be unaffordable to patients and unattractive to retailers.ThispaperreportsresultsfromaninterventionstudytestingthefeasibilityofRDTdistributioninUgandandrug shops. MethodsandFindings:92drugshopsin58villageswereofferedsubsidizedRDTsforsaleaftercompletingtraining.Data on RDT purchases, storage, administration and disposal were collected, and samples were sent for quality testing. Householdsurveyswereconductedtocapturetreatmentoutcomes.EstimateddailyRDTsalesvariedsubstantiallyacross shops,fromzeroto8.46RDTsperdays.Overallcompliancewithstorage,treatmentanddisposalguidelineswasexcellent. All RDTs (100%) collected from shops passed quality testing. The median price charged for RDTs was 1000USH ($0.40), corresponding to a 100% markup, and the same price as blood slides in local health clinics. RDTs affected treatment decisions.RDT-positivepatientswere23percentagepointsmorelikelytobuyArtemisininCombinationTherapies(ACTs) (p=.005)and33.1percentagepoi