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    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.


    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.


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“Sanitizing” The anti-malaria drug market

A call has been made for the cleaning up of the anti-malaria drug market to cut down on the less efficacious ones. The argument is that by limiting the number of branded anti-malarials on the market, it would help lessen the confusion among consumers. Consumers are sometimes exposed to many branded drugs and have to choose the best from the untidy heap of stocks produced by the different drug companies.

Ghana currently uses three drugs - artesunate-amodiaquine, (AA) artemether-lumefantrine (ALu) and dihydroartemisinin-piperaquine (DHAP) - for treating uncomplicated malaria.

However, between these generic drugs, are branded versions belonging to each of these three groups, and patients may have to go through a maze to settle on one.

While drug regulators also try, within limited logistics and personnel, to weed out fake and sub-standard drugs.

Dr Abraham Oduro, Director of the Navrongo Health Research Centre (NHRC), who made the call, has raised concerns and is calling on the authorities to allow few branded anti-malarials on the market, which have been critically assessed for efficacy and safety to protect consumers.

He was sharing his thoughts on the management of malaria during an interview with the AMMREN team that visited Navrongo to collect data on the phase 4 clinical study on eurartesim.

The Director explained that the Food and Drugs Authority (FDA) may be poorly equipped and not have the capacity to monitor several brands on the market and therefore the regulator and policy makers should identify and promote few efficacious drugs having active ingredients.

According to him, Ghana has fluid borders which makes it an uphill task for the FDA to check the different brands coming into town especially in periphery communities like Navrongo.

He pointed out that during the promotion of the anti-malaria drug with the green leaf logo under the Affordable Medicines Facility-malaria initiative, it was easy for the public to identify and go in for this drug with the belief that it was being promoted because it was efficacious and good.

Dr Oduro argues therefore that it would be best if selected branded drugs from specific companies, with proven track records are registered so people will recognize them and patronize them.

He said in medical science the prescribing habit is to go in for active ingredients or generic drugs and not branded drugs.

Unlike the other sites which also took part in the eurartesim trial, the Navrongo site extended the eurartesim safety trial to also cover the other modules such as effectiveness, adherence, efficacy, access and cost by using a new branded drug, duo-cotecxin.

Duo-cotecxin, just like eurartesim, belongs to the generic dihydro-artemisinin-piperaquine phosphate group of anti-malarials.

Dr Oduro explained that the Navrongo site did not use the eurartesim as a follow -up trial to assess the other modules because the sponsors could not get the manufacturers to produce the drug, which was out of stock. The site, therefore, had to go in for duo-cotecxin produced by a Chinese company.

He raised concerns over the fact that Ghana is using three first line drugs for the treatment of malaria. Dr. Oduro noted that it is not good for the country to throw in AA, ALu and DHAP drugs into the system and make them all first-line drugs in the health system.

He said the replacement of the three drugs would be difficult to come by because of the human and financial cost involved in finding replacements. He said it would have been appropriate to categorise the three in order of preference, with one being designated as a first line with a back up instead of making all three first line drugs.

Mr Emmanuel Yidana Ayamba, Research Officer at the NHRC, speaking on the general challenges involved in rolling out the eurartesim safety study said the trial was a complex procedure because of the intensity of the study which required that the study participants who were enrolled in the trial spend about six hours in the health facility for data to be collected on how the drug was performing on some vital organs in their body.

Mr Phillip Dalinjong, a Senior Health Research Officer at NHRC, said under the duo-cotecxin study, the cost effectiveness module's focus was on whether comparatively the cost of this drug is high, low ormoderate as compared to other ones in use such as AA and ALu to help policy makers and donors make a decision to deploy the drug in the health system.

He said data has been collected from households after deployment of the drug to see how the drug is performing in East Kassena-Nankana. The study supplied the duo-cotecxin drug to the health facilities at a cost of 3 cedis. Under the National Health Insurance Scheme it is going for 6 cedis 40 pesewas.

Mr. Maxwell Dalaba, Health Economist at NHRC, said the cost of treating malaria was part of the modules of the study, explaining that there were both direct and indirect costs, adding that malaria treatment costs should take on board the cost of transportation to improve access and management of the disease.

Mr Samuel Tamti Chatio, Senior Health Research Officer at NHRC, who focused on other modules of the study, said under the community acceptability module of the duo-cotecxin study, the research was looking at the perceptions and opinions of patients and health workers on the performance of the drug and also their knowledge and preference for other anti-malarials.

“We are conducting interviews with people who fall sick and are given duo-cotecxin he falls sick again, he will go in for the same drug,” Mr Tamti Chatio added.

Mr Thomas Anyorigiya, Senior Research officer at the NHRC and the INESS Coordinator, gave some overview about the entire INESS studies and said the studies were carried out in two districts- the Kassena-Nankana East Municipal and Kassena-Nankana West District.

He said the main reason for the INESS platform is to test malaria treatment to ensure that treatment is effective, appropriate diagnosis is carried out and the drugs are able to clear the malaria parasites.

“We evaluated the current treatment policy of malaria drugs and one key issue is that some people were not tested before treatment with AA and ALu within the districts....adherence was a big problem.”

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