Be informed wen deciding what anti-malaria medication to use

So-called health products reputedly containing artemisinins and marketed as effective in preventing malaria, can do more harm than good.

Dr Louis Hartley, who has a practice in Mbombela, says artemisinin-based combination therapies (ACTs) are the first line of treatment of the potentially fatal disease, but that products containing small amounts of ineffective artemisinins rather promote resistance to effective treatment than offer protection.

He expressed major concerns about a number of supposedly natural compounds being promoted as anti-malarial because they are reputed to contain artemisinins.

“These compounds are not effective in preventing malaria,” he said. More worrying is that the use of the products exposes the parasites to subtherapeutic levels of drugs that promote them developing resistance to effective treatment. Only a very limited number of artemisinins has antimalarial properties, Hartley explained.

“Even the effective artemisinins are not recommended for the prevention of malaria because their short half-life renders them completely unsuitable and ineffective for prevention. In addition, they are needed to be preserved for life-saving treatment. Hartley further pointed out that antimalarial drug resistance was the biggest threat to the control and eventual elimination of malaria.

“The continued use of oral artemisinin-based monotherapies in many parts of the world is considered to be a major contributing factor to the development and spread of resistance to artemisinin and its derivatives in Southeast Asia.

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The loss of artemisinin derivatives would have devastating consequences on people’s health in malaria-endemic countries and threaten the recent progress in malaria control achieved in many parts of the world.

“Many of these so-called health products do not in fact contain therapeutic doses of artemisinin and the majority have no anti-malarial effect.”

He pointed out that recognising the symptoms was crucial to successfully treat malaria.

The common symptoms of fever, chills and sweats, muscle pain and headaches were often misdiagnosed as flu, especially at this time of the year, and even a delay of a day or two in starting treatment may result in the development of complicated malaria – affecting especially the brain, kidneys and liver. He advised patients to inform their health practitioners of travel and possible malaria exposure, to insist on urgent blood tests (and repeating it if initially negative) and ensuring treatment with effective drugs.

“The optimal treatment is an artemisinin compound, which is used in combination with a second drug as a product in order to reduce the chances of malaria drug resistance developing.

“The efficacy of this artemisinin drug must be preserved, as no new class of antimalarial medicines is expected to enter the market within the next few years.

Artemisinin combination drugs currently serve as lifesaving treatments for people with falciparum malaria, the most severe form of the disease, particularly in young children.”

He further noted that the malaria risk for travellers, particularly those going to Mozambique, remained high and prevention was key.

People should prevent mosquito bites using DEET containing insect repellents applied to exposed skin from sunset to sunrise, the use of coils, where possible the use of air conditioning or fans in screened houses and dwellings and the use of preventative drugs for high-risk areas is recommended to reduce the chances of

being infected.

Hazyview Herald

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