National malaria management policy is based upon the availability of effective and affordable antimalarial drugs. This study was undertaken to evaluate the quality of the treatment of uncomplicated malaria cases in Bangui, an area with multi-drug resistant parasites, at a time preceding implementation of a new therapeutic policy relying on the artemisinin derivative combined treatment artemether-lumefantrine. A cross-sectional study was carried out in Bangui city to assess availability of antimalarial drugs and the performances of health workers in the management of uncomplicated malaria. Availability of drugs was recorded in all drugs wholesalers (n=3), all Pharmacies in health facilities (n=14), private drugstores (n=15), and on 60 non official drug shops randomly chosen in the city. Despite a limited efficacy at the time of the survey, chloroquine remained widely available in the official and non official markets. Artemisinin derivatives used in monotherapy or in combination were commonly sold. In health care facilities, 93% of the uncomplicated malaria cases were treated in the absence of any laboratory confirmation and the officially recommended treatment, amodiaquine-sulfadoxine/pyrimethamine was seldom prescribed. Thus, the national guidelines for the treatment of uncomplicated malaria are not followed by health professionals in Bangui. Its use should be implemented while a control of importation of drug has to be reinforced.
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Sudan J Paediatr
January 2024
Independent Consultant, Lawrenceville, Georgia, USA.
This is a brief review that highlights recent updates in malaria case management. Recent WHO revisions include a new artemisinin-based molecule (artesunate-pyronaridine), revising the recommendations for treating uncomplicated malaria during the first trimester of pregnancy and optimising primaquine dose to prevent relapses. The review also highlights innovative ideas to improve the implementation of guidelines for severe malaria and pre-referral treatment with rectal artesunate.
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Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
In 2023, Indonesia's Ministry of Health reported that nearly 75% of districts and cities in the country were free from malaria transmission, meaning 90% of the population lived in malaria-free zones. However, Papua Province, which accounts for only 1.5% of Indonesia's population, continues to contribute over 90% of the national malaria cases, with more than 16,000 reported cases in 2023.
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Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
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Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, China. Electronic address:
Artesunate, a semisynthetic derivative of artemisinin, is not only recommended as the first-line drug for treating severe malaria but is also a significant member of Artemisinin-based Combination Therapies (ACTs), used in combination with other artemisinin derivatives for treating uncomplicated malaria. Beyond its potent anti-malarial activity, artesunate has garnered considerable attention for its pharmacological effects, which encompass broad-spectrum anti-tumor, anti-viral, and anti-inflammatory properties. It has collectively demonstrated superior drug tolerance, low toxicity, and mild side effects in cell line experiments in vitro, experimental animal models, and clinical drug researches, as a monotherapy or in combination with other agents.
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January 2025
Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, People's Republic of China.
Drug resistance resulting from mutations in Plasmodium falciparum, that caused the failure of previously effective malaria drugs, has continued to threaten the global malaria elimination goal. This study describes the profiles of P. falciparum chloroquine resistance transporter (Pfcrt) and P.
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