Physical and chemical stability of expired fixed dose combination artemether-lumefantrine in uncontrolled tropical conditions

Roger Bate, Richard Tren, Kimberly Hess & Amir Attaran | 25 Feb 2009 | Malaria Journal

New artemisinin combination therapies pose difficulties of implementation in developing and tropical settings because they have a short shelf-life (two years) relative to the medicines they replace. This limits the reliability and cost of treatment, and the acceptability of this treatment to health care workers. A multi-pronged investigation was made into the chemical and physical stability of fixed dose combination artemether-lumefantrine (FDC-ALU) stored under heterogeneous, uncontrolled African conditions, to probe if a shelf-life extension might be possible.

Failure of artesunate-mefloquine combination therapy for uncomplicated Plasmodium falciparum malaria in southern Cambodia

William Rogers et al | 12 Jan 2009 | Malaria Journal

Resistance to anti-malarial drugs hampers control efforts and increases the risk of morbidity and mortality from malaria. The efficacy of standard therapies for uncomplicated Plasmodium falciparum and Plasmodium vivax malaria was assessed in Chumkiri, Kampot Province, Cambodia.

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

Christopher JM Whitty et al | 11 Dec 2008 | Malaria Journal

Following a long period when the effectiveness of existing mono-therapies for antimalarials was steadily declining with no clear alternative, most malaria-endemic countries in Africa and Asia have adopted artemisinin combination therapy (ACT) as antimalarial drug policy.

Trends in malaria morbidity following the introduction of artesunate plus amodiaquine combination in M'lomp village dispensary, south-western Senegal

Sophie Sarrassat, Paul Senghor & Jean Yves Le Hesran | 24 Oct 2008 | Malaria Journal

In Thailand, South Africa and Zanzibar, a decrease in malaria morbidity was observed following the introduction of artemisinin-based combination therapy (ACT). In Senegal, therapeutic trials supervised the in vivo efficacy of artesunate plus amodiaquine from 1999 to 2005 at the M'lomp village dispensary. The trends in malaria morbidity in this village were evaluated from 2000 to 2002.

A Nationwide Survey of the Quality of Antimalarials in Retail Outlets in Tanzania

Harparkash Kaur et al | 15 Oct 2008 | PLoS One

Retail pharmaceutical products are commonly used to treat fever and malaria in sub-Saharan African countries. Small scale studies have suggested that poor quality antimalarials are widespread throughout the region, but nationwide data are not available that could lead to generalizable conclusions about the extent to which poor quality drugs are available in African communities. This study aimed to assess the quality of antimalarials available from retail outlets across mainland Tanzania.

Quantity and Quality: An Rx for Efficient Drug Purchasing

Roger Bate & Karen Porter | 18 Sep 2008 | American Enterprise Institute

Drug procurement agencies and organizations spend billions of dollars on drugs for patients in the developing world. These drugs are essential to the health of many millions of patients--but only if they are safe and effective. The World Health Organization (WHO) and the Global Fund to Fight AIDS, Tuberculosis and Malaria offer "prequalification" programs designed to help drug procurers identify suppliers of safe and effective drugs.

Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania

Manuel W Hetzel et al | 16 Sep 2008 | BMC Public Health

Malaria is still a leading child killer in sub-Saharan Africa. Yet, access to prompt and effective malaria treatment, a mainstay of any malaria control strategy, is sub-optimal in many settings. Little is known about obstacles to treatment and community-effectiveness of case-management strategies. This research quantified treatment seeking behaviour and access to treatment in a highly endemic rural Tanzanian community. The aim was to provide a better understanding of obstacles to treatment access in order to develop practical and cost-effective interventions.

Malaria Treatment in Africa

None | 07 May 2008 | Africa Fighting Malaria

This report discusses some of the recent successes and great challenges in malaria treatment, notably exposing some of the policy reforms needed to achieve a sustained improvement in malaria treatment outcomes in Africa. The key recommendations at the beginning of this report and at the conclusion of each section summarize these issues and suggest constructive ways forward.

Antimalarial Drug Quality in the Most Severely Malarious Parts of Africa - A Six Country Study

Roger Bate, Philip Coticelli, Richard Tren & Amir Attaran | 07 May 2008 | PLoS One

A range of antimalarial drugs were procured from private pharmacies in urban and peri-urban areas in the major cities of six African countries, situated in the part of that continent and the world that is most highly endemic for malaria. Semi-quantitative thin-layer chromatography (TLC) and dissolution testing were used to measure active pharmaceutical ingredient content against internationally acceptable standards.

Efficacy and safety of artemisinin-based antimalarial in the treatment of uncomplicated malaria in children in southern Tanzania

Kabanywanyi et al. | 11 Nov 2007 | Malaria Journal

Tanzania switched the antimalarial first line to sulphadoxine-pyrimethamine (SP) in 2001 from ineffective chloroquine (CQ). By 2003 higher levels of SP resistance were recorded, prompting an urgent need for replacing the first line drug with ACT, as currently recommended by the World Health Organization. Despite this recommendation country-specific evidence-based data to support efficacy and safety profile of ACT is still limited. A study on the efficacy and safety of artesunate plus amodiaquine (AS+AQ) and artemether plus lumefantrine (AL)(Coartem(R)) was carried out in 2004 with the view of supporting the National Malaria Control Programme in the review of the policy in mainland Tanzania.