The “Test, Treat and Track (T3)” policy, introduced by the National Malaria Control Program (NMCP) in 2010 aims to ensure that all suspected malaria cases receive laboratory confirmatory tests (RDT/ microscopy) before treatment with recommended oral artemisinin-based combination therapies (ACTs). This study assessed the relationship between confirmed malaria cases and ACT consumption 4 years after the introduction of the T3 policy in the Ningo Prampram District of Ghana.
Extraction, isolation and purification of a biomarker from the powdered stem bark of the plant was carried out using column chromatography on silica and sephadex LH 20.The isolated biomarker was characterized and identified as Regiafuran A using detailed NMR spectroscopy (1D and 2D). A reverse-phase (RP) HPLC method using μBondapakTM C18 (3.9×300 mm, 5 μm) column with PDA detection (250nm), gradient elution; 0.1% Trifluoroacetic acid (A) and Methanol (B), was developed to analyse the biomarker.
Results and Discussion
Between January 2015 and April 2018, a total of 75,496 suspected malaria cases were seen in the district of which 27,738 (36.7%) were confirmed. An average of 52.0% (95% CI: 49.3% -54.7%) of suspected malaria cases were confirmed per month per facility. Furthermore,59.1% (95% CI: 56.4% – 61.9%) of suspected malaria cases were treated with ACTs per month per facility. A significant linear relationship was observed between confirmed malaria cases and ACT treatments (R2 = 0.184, P < 0.00001). Additionally, it was observed that, in the absence of confirmed malaria cases (intercept), an average of 55 suspected malaria cases were treated with ACT per month per facility (P < 0.00001).
The study successfully demonstrated a linear relationship between confirmed malaria cases and ACT use. Aside confirmed cases, other factors may potentially contribute to ACT consumption. This calls for further studies to assess the impact of the T3 policy on ACT consumption.