Antimalarial treatment with artemisinin combination therapy in Africa desirable, achievable, but not easy
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Date
2005
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ
Abstract
The steady increase of drug resistant malaria across Africa is a crisis for which there are achievable solutions, but no easy ones. The scale of the problem is not in doubt. In Africa malaria remains one of the commonest causes of death and serious morbidity, especially for children and pregnant women.1 Despite a decision in principle by many countries in Africa to use artemisinin based combination therapies (ACTs), most cases of malaria are still treated with monotherapy and in many areas most of these treatments will fail.2 3
Drug combinations, rather than monotherapy, are now seen to be the best solution for treating malaria, and artemisinin based drug combinations are highly effective, with cure rates similar to that of chloroquine 30 years ago. They seem to be a good long term choice for most African countries, being safe and well tolerated (with the caveat that their safety in early pregnancy is not yet clear). Compared with other antimalarials, ACTs can reduce gametocyte carriage and thereby lower the risk of infectiousness in those who take treatment. In areas of relatively low malaria transmission in South East Asia and South Africa, widespread use of ACTs has reduced significantly the burden of malaria.4 This benefit is likely be less marked in areas of very high transmission in Africa, where much of the reservoir of malaria infection is in asymptomatic people who never seek treatment.
Description
Keywords
Africa, Artemisinin, Antimalaria
Citation
Malenga, G., Palmer, A., Staedke, S., Kazadi, W., Mutabingwa, T., Ansah, E., Barnes, K.I. and Whitty, C.J., 2005. Antimalarial treatment with artemisinin combination therapy in Africa.