{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T22:28:53Z","timestamp":1785364133409,"version":"3.55.0"},"reference-count":40,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Prompt diagnosis and effective treatment are key malaria interventions that rely on community knowledge and adherence to treatment. With the emergence of artemisinin resistance in Rwanda, ensuring optimal malaria treatment practices within communities is essential. This study examined malaria knowledge, attitudes, and practices among febrile patients at government clinics to identify factors influencing malaria treatment practices. A cross-sectional study was conducted in six health facilities in moderate- to high-malaria-transmission areas of Rwanda. Patients or caregivers of children with fevers were enrolled and interviewed using semistructured questionnaires. From December 2023 to February 2024, 406 participants were enrolled; 71% (\n                    <jats:italic>n<\/jats:italic>\n                    = 289\/406) of participants owned insecticide-treated nets, and 51% (\n                    <jats:italic>n<\/jats:italic>\n                    = 205\/406) received indoor residual spraying. Malaria knowledge was high among respondents, with 81% (\n                    <jats:italic>n<\/jats:italic>\n                    = 329\/406) correctly identifying symptoms, 72% (\n                    <jats:italic>n<\/jats:italic>\n                    = 291\/406) understanding transmission modes, and 74.6% (\n                    <jats:italic>n<\/jats:italic>\n                    = 303\/406) aware of effective control measures. However, of the 44.3% (\n                    <jats:italic>n<\/jats:italic>\n                    = 180\/406) who received malaria treatment in the last 6 months, only 46% (\n                    <jats:italic>n<\/jats:italic>\n                    = 83\/180) completed the appropriate 3-day medication course; 37% (\n                    <jats:italic>n<\/jats:italic>\n                    = 66\/180) stopped within 2 days, and 11% (\n                    <jats:italic>n<\/jats:italic>\n                    = 19\/180) went over 3 days. Furthermore, 27% (\n                    <jats:italic>n<\/jats:italic>\n                    = 109\/406) took antimalarials for fever; the majority (54%;\n                    <jats:italic>n<\/jats:italic>\n                    = 49\/109) received medication from drug outlets\/pharmacies. Although knowledge and attitudes toward malaria treatment were high, adherence was poor, thereby exacerbating the risk of developing resistance. Effective interventions are urgently needed to improve antimalarial adherence, particularly in sub-Saharan African countries with documented antimalarial resistance.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0061","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T16:48:18Z","timestamp":1761670098000},"page":"1279-1288","source":"Crossref","is-referenced-by-count":2,"title":["Understanding Malaria Treatment Adherence in Rwanda: Implications for Artemisinin Resistance"],"prefix":"10.4269","volume":"113","author":[{"given":"Pierre","family":"Gashema","sequence":"first","affiliation":[{"name":"College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom;"},{"name":"Center for Genomic Biology, INES-Ruhengeri, Ruhengeri, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aileen","family":"Jordan","sequence":"additional","affiliation":[{"name":"College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Saramba","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeva","family":"Wernsman Young","sequence":"additional","affiliation":[{"name":"Center for Computational Molecular Biology, Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick Gad","family":"Iradukunda","sequence":"additional","affiliation":[{"name":"Repolicy Research Centre, Kigali, Rwanda;"},{"name":"Drug Department, Rwanda Food and Drugs Authority, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine","family":"Karema","sequence":"additional","affiliation":[{"name":"Quality Equity Health Care, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Baptiste","family":"Mazarati","sequence":"additional","affiliation":[{"name":"Center for Genomic Biology, INES-Ruhengeri, Ruhengeri, Rwanda;"},{"name":"Quality Equity Health Care, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J.","family":"Juliano","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Center for Computational Molecular Biology, Brown University, Providence, Rhode Island;"},{"name":"Department of Pathology, Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Banek","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina;"},{"name":"Department of Epidemiology, Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"World Malaria Report 2023.","year":"2023"},{"key":"b2","series-title":"Am J Trop Med Hyg","first-page":"99","article-title":"Impact evaluation of malaria control interventions on morbidity and all-cause child mortality in Rwanda, 2000\u20132010","volume":"97","author":"Eckert","year":"2017"},{"key":"b3","series-title":"Malar J","first-page":"236","article-title":"Trends in malaria cases, hospital admissions and deaths following scale-up of anti-malarial interventions, 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artemisinin-based combination therapy for the treatment of malaria: A systematic review of the evidence","volume":"13","author":"Banek","year":"2014"},{"key":"b24","series-title":"Malar J","first-page":"99","article-title":"Knowledge and behaviour as determinants of anti-malarial drug use in a peri-urban population from malaria holoendemic region of western Kenya","volume":"10","author":"Watsierah","year":"2011"},{"key":"b25","series-title":"Malar J","first-page":"281","article-title":"Adherence to prescribed artemisinin-based combination therapy in Garissa and Bunyala districts, Kenya","volume":"10","author":"Lawford","year":"2011"},{"key":"b26","series-title":"Malar J","first-page":"1","article-title":"Factors influencing patients\u2019 adherence to malaria artemisinin-based combination therapy in Kamuli District, Uganda","volume":"23","author":"Bawate","year":"2024"},{"key":"b27","series-title":"Malar J","first-page":"87","article-title":"Are Tanzanian patients attending public 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