Uganda: Anti-Malarials - What Drug Works Best?

	Email This Page Print This Page Comment on this article

The Monitor (Kampala)

14 August 2008
Posted to the web 14 August 2008

Claire Nabwire

According to statistics from the ministry of Health, Malaria accounts for up to 40 percent of all out patient visits at health centres.

The disease poses a significant threat to the population. Many people in Uganda today are however fast to rush to pharmacies when they experience signs of malaria that include constant headaches, general weakness and nausea, among others. Some will buy fansidar, others artemether.

There are different antimalarial drugs such as fansidar, chloroquine, quinine, coartem, lumartem, artequine, lonart, piperaquine, lumefantrine, mefloquine, artesunate and artemether, among others. However, artemether/lumefantrine and artemether/amodiaquine are the common combinations in Uganda.

According to Steven Sendagire, a pharmacist, there are numerous antimalarial treatments because different patients have different requirements.

"A treatment that is good for one patient might not be effective on a different patient," he said. It can be quite fatal if one took a drug that he or she shouldn't have.

A pregnant woman, for instance, is not supposed to take coartem during her first three months of pregnancy. "Before putting it on the market, the drug was not tested on pregnant women and so we don't really know what would happen if one took it.

However, we are not willing to risk it because the first three months are the crucial months. It is when most changes are taking place," he explained.

According to Dr Arthur Kwizera, a general practitioner at Mulago Hospital, coartem is a combination of drugs that is known to cause cardiac arrest if given to women during their first three months of pregnancy.

In the same way, amodiaquine must not be taken by anaemic patients. Anaemia means one's blood count is low. The effect of amodiaquine is to reduce the blood levels. It is therefore fatal for an anaemia patient to take amodiaquine. Ssendagire added that psychiatric patients must not take nefloquine.

When you are feeling unwell, go the doctor who will examine you and prescribe drugs accordingly. "Malaria is classified as either severe or simple," Ssendagire pointed out.

Severe malaria has symptoms such as convulsions, dehydration, unconsciousness, and low blood sugar levels, among others, in addition to the common ones (headache, dizziness.) A patient with severe malaria therefore cannot be given the same treatment as one with simple malaria. That is why diagnosis is important. We have heard of cases where patients are diagnosed with malaria and others with malaria +++.

Combined treatment

Ssendagire pointed out that, "For the management of uncomplicated malaria, the World Health Organisation (WHO) and the Uganda Ministry of Health recommend the use of Artemesinin Combination Therapy (ACT), like artesunate and artemether."

He says that these artemesinin derivatives must be taken in combination with other drugs. Dr Kwizera says malaria treatment is supposed to be double therapy; for instance a patient is given artemether with fansidar.

If your doctor doesn't prescribe a double treatment, insist. "If the artemesinin drugs are taken on their own, resistance could set in thus no effective treatment or cure for the sickness," Dr Kwizera warns.

Ssendagire pointed out that antimalarials are not only used to cure malaria but to prevent it as well. "Pregnant women, for instance, are given fansidar to prevent malaria," he said.

Relevant Links East Africa Health and Medicine Malaria Uganda

The pharmacist points out that a fever might not necessarily mean you already have malaria. It is therefore important that as soon as you feel unwell, you go to a clinic or hospital. When your blood has been checked, your doctor will be able to know if you are already infected and therefore choose the appropriate drugs.

--
Jean-Louis Kayitenkore
Procurement Consultant
Gsm: +250-08470205
Home: +250-55104140
P.O. Box 3867
Kigali-Rwanda
East Africa
Blog: http://www.cepgl.blogspot.com
Skype ID : Kayisa66