Background: Adherence to radical cure for Plasmodium vivax is a critical component to achieve malaria elimination. Little is known about patients’ motives and the socio-cultural factors driving adherence or non-adherence. This study assessed adherence to and acceptance of 14-day radical cure for P. vivax malaria in the context of a cluster randomized trial assessing the effectiveness of unsupervised versus supervised primaquine treatment in patients with uncomplicated malaria.
Methodology: A mixed methods study was conducted in all clusters of the trial (supervised 14-day primaquine, unsupervised 14-day primaquine, and a control arm treated per standard protocol). The structured questionnaire used in the quantitative patient survey was based on insights from an exploratory qualitative study consisting of interviews and participant observation. The survey aimed to assess adherence to radical cure and other malaria treatments; perceptions of malaria; and health seeking behavior.
Results: The qualitative study indicated that in contrast to standard malaria treatments that are widely accepted, primaquine is a poorly understood drug and for this reason the need to adhere to a full course is often considered less important. The quantitative patient survey will be completed at the end of April, and the full results presented .
Conclusion: In a setting with high malaria endemicity, familiarity with a drug and understanding of its action affects treatment adherence.