AUTHOR=Laktabai Jeremiah , Platt Alyssa C. , Turner Elizabeth , Saran Indrani , Kipkoech Joseph , Menya Diana , O’Meara Wendy Prudhomme 

TITLE=Community-Based Malaria Testing Reduces Polypharmacy in a Population-Based Survey of Febrile Illness in Western Kenya

JOURNAL=International Journal of Public Health

VOLUME=Volume 67 - 2022

YEAR=2022

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2022.1604826

DOI=10.3389/ijph.2022.1604826

ISSN=1661-8564

ABSTRACT=Objective. To describe the type and number of medicines consumed for febrile illnesses, based on malaria test result and where care was provided. We hypothesized that community based access to malaria testing would reduce dual consumption of antimalarials and antibiotics but could increase antibiotic use among malaria-negative cases.
Methods:  This is a secondary analysis of a cluster-randomized trial of an intervention designed to increase diagnostic testing and targeting of Artemesinin Combined Therapies (ACTs) using data from baseline, 12 and 18 months of follow-up.
Results: Of 5,756 participants analyzed, 60.1% were female, 42% were aged 5-17 years and 58.1% sought care for fever in a retail outlet. Consumption of both ACT and antibiotics was 22.1%(n=443/2008) at baseline. At endline, dual consumption had declined to 16.6%. There was reduced antibiotic consumption among those testing positive for malaria (39.5% to 26.5%) and those testing negative (63.4% to 55.1%), accompanied by a substantial decline in ACT use among malaria-negative participants.
Conclusion: Diagnostic testing for malaria reduces dual consumption of ACTs and antibiotics, especially among those testing outside the formal healthcare sector.