Uganda Endorses Chinese Anti-malarial Drug to Curb Deaths

Uganda's ministry of health has approved the use of Artesunate, a Chinese made anti-malarial drug to help treat severe cases of malaria, a disease that kills over 320 people per day, mostly children and pregnant mothers.

Peter Okui, the Malaria Control Program manager, told a scientific symposium held recently that Artesunate, which is used to treat severe malaria in both adults and children, should be used in preference to Quinine.

Artesunate was recommended by the World Health Organization after studies conducted in Asia and Africa showed a reduction in morbidity and mortality.

The injectable medicine is said to be rapidly absorbed into the body within five minutes compared to Quinine which takes over 30 minutes.

In southeast Asia, a 2005 study showed the use of Artesunate resulted in 35 percent fewer deaths in adults while a similar study in nine African countries showed 23 percent reduction in child deaths. BURDEN

Claiming over 320 lives daily, malaria is Uganda's leading cause of morbidity and mortality and is endemic in 95 percent of the country.

According to the ministry of health, malaria accounts for 25 percent to 40 percent of outpatient visits to health facilities and is responsible for nearly half of inpatient pediatric deaths. The disease consumes 10 percent of the ministry of health budget and 25 percent of household incomes.

If not treated urgently, uncomplicated malaria progresses into severe malaria exhibiting symptoms of repeated convulsion, coma, and serve anaemia.

"Severe malaria is a very serious complication of malaria. It is severe because unless it is treated it causes death. Even with treatment, more than 5 percent of the children die," Richard Idro, a pediatrician at Mulago Hospital, Uganda's major referral hospital told Xinhua.

People prone to severe malaria include visitors to the country from places where there is no malaria and people in Uganda where there is low incidences of malaria.

People from places of high incidences of malaria develop some form of immunity because of the several bouts they have gotten over a period of time. CHINESE HELP

According to the ministry of health, Uganda's major challenge to the effective malaria case management is the emergence of parasite resistance to anti-malarial medicine.

Several approved drugs like Chloroquine and Quinine have gotten failure rates because of their inappropriate use.

In 2000, a monotherapy with chloroquine was associated with a failure rate of 28 percent in patients aged 5 years old to 76 percent in children under five, according to the ministry of health.

Experts now believe proper use of Artesunate, manufactured by a Chinese pharmaceutical company, Guilin Pharma Limited, will reduce malaria deaths.

At the symposium which was attended by senior paediatricians and health workers in the country, the Chinese government at the request of its Ugandan counterpart pledged to provide about 240, 000 boxes of Artesunate.

Jing Yanhui, an official at the Economic and Commercial Counselor's Office at the Chinese embassy described in a statement to the symposium held on June 15 that China's support to Uganda on anti-malaria is comprehensive and enduring.

"From 2006 to 2011, our government has donated 1.5 million boxes of anti-malaria medicines, worth 20 million yuan (3.1 million U.S. dollars), to the Ugandan government. In addition, China-Uganda Malaria Prevention and Treatment Center, which is attached to Mulago Hospital, was put up in 2008," he said.

The Chinese government has also funded tens of Ugandan doctors to attended anti-malaria seminars in China, he said.

In order to reduce on the crowds at Mulago Hospital located in the capital Kampala, the Chinese government provided funds to construct a 100-bed referral hospital in Naguru, which is named China-Uganda Friendship Hospital.

Jing said that in order to ensure that the Friendship Hospital is running smoothly and successfully, the Chinese government would continue to provide additional necessary medical equipment and supplies worth 10 million yuan, and a Chinese medical team has moved into the hospital to work with their Ugandan counterparts.

Another Malaria Prevention and Treatment Center is going to be established in this hospital in the near future, according to Jing.

Okui described the Chinese donations as a boost to the fight against malaria. SUCCESS

According to the ministry of health, although there is no readily available statistics, there are indications that the malaria incidence in the country is reducing.

This is partly attributed to increased access to insecticide- treated mosquito nets and indoor residual spraying.

Ministry of health statistics showed 7.3 million nets were distributed in the past one year alone while another one million is to be distributed in October this year.

The latest World Health Organization's (WHO) global malaria report showed the percentage of Ugandan households owning at least one mosquito net has risen from 2 percent in 2000 to 46 percent in 2010.

Among the most at risk population, at least 33 percent of children under the age of five sleep under treated nets, as well as 77 percent of pregnant women, according to the report released last year.

The success is also partly attributed to the training of Village Health Teams (VHTs) in an integrated Community Case Management program aiming to expand and improve the diagnosis and treatment of malaria at the community level.

VHTs are equipped to appropriately diagnose and treat the disease within the first 24 hours of symptom onset, increasing the chances that a child will survive.

However, experts warned that despite the successes, the government must boost funding for malaria control, noting that over 90 percent of the funds come from donors.

They noted that in view of the effects of the global economic crisis that has ravaged the country's donors, funding to the fight against malaria may go down leading to the increase in the malaria burden.

CRJ
19 June 2012