Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities

Whitty, Christopher J M; Chandler, Clare I R; Ansah, Evelyn; Leslie, Toby; Staedke, Sarah G.

doi:10.1186/1475-2875-7-s1-s7

Cited by 115 publications

(102 citation statements)

References 57 publications

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“…To reduce malaria over diagnosis and misdiagnosis that occur in malaria endemic countries in Africa and Asia [11], the World Health Organization in 2010 recommended that diagnosis of malaria should be confirmed through parasite-based test; which could be Microscopy or Rapid Diagnostic Test (RDT) before commencement of treatment [10]. It is a good finding that 90.7% of the doctors working in the three key departments in the hospital that manage malaria cases were knowledgeable about this.…”

Section: Discussionmentioning

confidence: 99%

“…This is to minimize malaria over diagnosis and misdiagnosis observed in malaria endemic countries in Africa and Asia [11]. Microscopy is the gold standard for malaria diagnosis, but it has some drawbacks such as being dependent on trained and skilled personnel, availability of power supply, and availability of consumables required for microscopy [12].…”

Section: Introductionmentioning

confidence: 99%

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Knowledge and Perception of Malaria Rapid Diagnostic Test among Medical Doctors in a South Eastern Nigeria Tertiary Hospital

Ndibuagu¹,

Amadi²,

Ugwu³

2017

JBM

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Malaria commonly causes fever in tropical Africa. In 2010, World Health Organization recommended parasitological diagnosis of malaria before treatment. Rapid Diagnostic Test (RDT) aims at making malaria diagnosis more accessible. The objective of this study was to assess knowledge, and perception of malaria rapid diagnostic test (mRDT), among doctors in a tertiary health facility. A descriptive, cross sectional study, conducted in October 2016, in a state University Teaching hospital, Enugu state, Nigeria. 86 doctors in the General Outpatient, Internal Medicine, and Paediatrics departments participated. 90.7% of respondents knew parasitological examination of blood is the certain method of making malaria diagnosis, 89.5% knew microscopy and RDT are methods for parasitological diagnosis, 91.9% knew mRDT is quick blood test for malaria, 54.7% knew mRDT is usually specific for one or more species of malaria, 46.5% knew mRDT detects circulating malaria parasite antigen, 29.1% knew mRDT is read 15 to 20 minutes after the test, 70.9% knew mRDT is not superior to microscopy, 79.1% knew mRDT is not 100% specific, 80.2% knew mRDT ought not be done always by Laboratory Scientists, and 66.3% knew more than one type of mRDT kit is available. On perception, 64.0% thought it was important to confirm diagnosis before commencing treatment, 90.7% perceived mRDT as being very useful, 96.5% did not perceive mRDT as endangering patients, 70.9% opinioned that presumptive diagnosis of malaria is not a better way of making diagnosis, 76.7% did not believe malaria diagnosis is always clear on listening to the patient, 90.7% did not perceive mRDT as being hazardous, 83.7% believe using mRDT can reduce the quantity of anti-malaria drugs consumed, and 94.2% opinioned that mRDT should be encouraged and promoted. Training and re-training of health workers shall greatly enhance mRDT use in implementing the WHO How to cite this paper: Ndibuagu, E.O.,

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Knowledge and Perception of Malaria Rapid Diagnostic Test among Medical Doctors in a South Eastern Nigeria Tertiary Hospital

Ndibuagu¹,

Amadi²,

Ugwu³

2017

JBM

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“…(2) No evidence supported including diagnostic testing with a subsidy for antimalarials, although all agreed that increasing the use of diagnostic tests was another priority. 22 (3) No other practicable mechanisms in place of, or in addition to, a global subsidy would be better at reaching the poorest of the poor. Agreement was nearly unanimous that implementation of the AMFm should not be delayed, with continued recognition of the need for careful monitoring and operational research, which had been articulated originally by the IOM committee.…”

Section: From Plan To Implementationmentioning

confidence: 99%

A Global Subsidy: Key To Affordable Drugs For Malaria?

Laxminarayan¹,

Gelband

2009

Health Affairs

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ABSTRACT:The global fight against malaria has been continually challenged by poor access to affordable, effective medicine. Growing resistance to chloroquine, the traditional treatment, has worsened the situation. Artemisinins, the successor therapy to chloroquine, are at least ten times more costly than the older drug. In developing countries, most malaria medicines are purchased in the private sector, where traditional aid mechanisms do not reach. So a new aid approach was needed. The Affordable Medicines Facility-malaria (AMFm) will efficiently supply publicly subsidized drugs to meet public-and private-sector demand in malaria-endemic countries. If artemisinins are priced more competitively, resistance to them will be delayed. [Health Affairs 28, no. 4 (2009): 949-961; 10.1377/hlthaff .28.4.949] C h l o r o q u i n e wa s t h e o r i g i na l m i r ac le d ru g for malaria-effective for half a century in Africa, safe, and cheap. Despite the spread of chloroquine-resistant malaria parasites (Plasmodium falciparum) throughout Southeast Asia beginning in the 1960s, no plans were laid for replacing chloroquine throughout Africa until it was failing in a big way, toward the end of the 1990s. Even though it was clear that no other available and relatively inexpensive drugs would last more than few years before resistance set in, there was no movement to introduce the single best new alternative: the artemisinin compounds. In use in Asia for decades, artemisinin compounds-derived from the plant species Artemisia annua-are heirs apparent to chloroquine.No serious attempt was ever made to try to preserve chloroquine's effectiveness by promoting combination therapy, now the standard in infectious diseases such as tuberculosis and HIV/AIDS. But with no backup for the artemisinins, malaria thought leaders began laying out a case for delaying their (inevitable) loss to resistance by using them only in combination with another antimalarial.1 The partner drugs would protect the artemisinin by killing any parasites that, by chance, contained an artemisinin resistance mutation. Partner drugs would also be protected

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“…Alternative therapies such as artemisinin combinations for treatment of CQ-resistant malaria parasite infections have been developed. However, these therapies do not meet the simplicity of use and low cost of CQ (55).…”

mentioning

confidence: 99%

Novel 4-Aminoquinoline Analogs Highly Active against the Blood and Sexual Stages of Plasmodium In Vivo and In Vitro

Saénz

Mutka

Udenze

et al. 2012

Antimicrob Agents Chemother

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New drugs to treat malaria must act rapidly and be highly potent against asexual blood stages, well tolerated, and affordable to residents of regions of endemicity. This was the case with chloroquine (CQ), a 4-aminoquinoline drug used for the prevention and treatment of malaria. However, since the 1960s, Plasmodium falciparum resistance to this drug has spread globally, and more recently, emerging resistance to CQ by Plasmodium vivax threatens the health of 70 to 320 million people annually. Despite the emergence of CQ resistance, synthetic quinoline derivatives remain validated leads for new drug discovery, especially if they are effective against CQ-resistant strains of malaria. In this study, we investigated the activities of two novel 4-aminoquinoline derivatives, TDR 58845, N 1 -(7-chloro-quinolin-4-yl)-2-methyl-propane-1,2-diamine, and TDR 58846, N 1 -(7-chloro-quinolin-4-yl)-2,N 2 ,N 2 -trimethylpropane-1,2-diamine and found them to be active against P. falciparum in vitro and Plasmodium berghei in vivo. The P. falciparum clones and isolates tested were susceptible to TDR 58845 and TDR 58846 (50% inhibitory concentrations [IC 50 s] ranging from 5.52 to 89.8 nM), including the CQ-resistant reference clone W2 and two multidrug-resistant parasites recently isolated from Thailand and Cambodia. Moreover, these 4-aminoquinolines were active against early and late P. falciparum gametocyte stages and cured BALB/c mice infected with P. berghei. TDR 58845 and TDR 58846 at 40 mg/kg were sufficient to cure mice, and total doses of 480 mg/kg of body weight were well tolerated. Our findings suggest these novel 4-aminoquinolines should be considered for development as potent antimalarials that can be used in combination to treat multidrug-resistant P. falciparum and P. vivax.

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Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities

Cited by 115 publications

References 57 publications

Knowledge and Perception of Malaria Rapid Diagnostic Test among Medical Doctors in a South Eastern Nigeria Tertiary Hospital

Knowledge and Perception of Malaria Rapid Diagnostic Test among Medical Doctors in a South Eastern Nigeria Tertiary Hospital

A Global Subsidy: Key To Affordable Drugs For Malaria?

Novel 4-Aminoquinoline Analogs Highly Active against the Blood and Sexual Stages of Plasmodium In Vivo and In Vitro

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