A Roadmap For Deployment Of A Fixed Dose Triple Combination of Artemether-Lumefantrine-Amodiaquine In Uganda.
Design
Qualitative study
Contexte
The WHO African Region continues to bear the overwhelming burden of malaria, accounting for 93.6% of global malaria cases and 95.4% of malaria-related deaths in 2022. Artemisinin-based combination therapies (ACTs) remain the cornerstone of malaria treatment; however, the emergence of artemisinin resistance in countries such as Uganda, Rwanda, Ethiopia, Eritrea, and Tanzania poses a significant threat to malaria control and elimination efforts across the continent.
To address this challenge, Triple Artemisinin-based Combination Therapies (TACTs) have been developed to delay the emergence and spread of antimalarial drug resistance. TACTs combine one artemisinin derivative with two partner drugs that have complementary resistance profiles, thereby enhancing treatment durability. Among the TACTs currently under development, Artemether-Lumefantrine plus Amodiaquine (ALAQ) is a promising fixed-dose formulation. Early planning for the introduction of ALAQ can help identify and address potential implementation challenges, facilitating a smoother adoption process and supporting the long-term effectiveness of malaria treatment strategies.
The aim of this study is to inform relevant policy makers of the impending availability of a fixed dose combination of Artemether-Lumefantrine-Amodiaquine (ALAQ), including information regarding the safety, tolerability, efficacy, dosing, packaging, costs, timeline to availability of ALAQ and thereafter to develop a roadmap to enable swift deployment of FDC ALAQ in Uganda when it becomes available.
Our role
Coordination
Partners
- National Malaria Control Program, Ministry of Health in Uganda
- Finding: University of Oxford, United Kingdom
Objectives
- Main objective
- To identify and address obstacles in implementation and deployment of FDC ALAQ at an early stage and contribute to the smooth introduction of FDC ALAQ in Uganda.
- Specific objectives:
- To identify and engage with key national stakeholders involved in Malaria control and introducing new antimalarials in Uganda.
- To obtain understanding into relevant policy, regulatory and implementation procedures of new antimalarials and to identify areas that require strategic attention before any new antimalarials are introduced in Uganda.
- To develop a practical roadmap that can be used for the effective introduction and deployment of FDC ALAQ in Uganda aiming to control and contain artemisinin resistance in Uganda.
Methodology
The study employed the Delphi method, a structured qualitative research methodology that facilitates consensus among a panel of experts facilitates consensus on best practices and strategies through an iterative process of collecting and refining opinions of the different stakeholders.
Participant selection involved identifying and inviting relevant stakeholders in the Ugandan healthcare system involved in malaria management and introduction of new therapies.
Round one data collection involved Key informant interviews conducted with the different stakeholders . This data was rapidly analyzed. A summary of key themes from round one of interviews were presented in the 2 day workshop to the stakeholders and Focused group discussions (round 2 data collection) were held to refine the findings.
Significance
The study will result in a roadmap to support the roll-out and implementation of FDC ALAQ, and will be presented to the National Malaria Control Program, Ministry of Health in Uganda. In addition during this study, the stakeholders involved in policy formulation regarding Malaria control programs will garner more knowledge on artemisinin resistance, its impact on malaria eradication and control and various ways in which it is being combated globally translating to better malaria control efforts in Uganda especially regarding artemisinin resistance.
