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TIPS ON MALARIA

  • HOW CAN MOSQUITOES BE CONTROLLED?

    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.

  • HOW CAN I PROTECT MYSELF FROM MOSQUITO-BORN DISEASES?

    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.

  • WHO ARE AT RISK?


    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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The Manhiça Health Research Centre (Centro de Investigaçãoem Saúde de Manhiça (CISM)) in Mozambique, was created in 1996 to promote and conduct biomedical research in priority    health    areas.    One    of the    recent    INESS    studies    undertaken by CISM since 2011 is the assessment    of new    anti-malarial drugs.    

CISM recently took part    in the trial into the Eurartesim drug. Mbarwa Kivuyo and Teresa Machai interviewed the Eurartesim Study    Principal Investigator,    Dr. Esperanca Sevene, about the drug trial.    

Q: Your site recently took part in the trial into the Eurartesim drug. What was it all about?

R: This    was a study to assess the safety of a new anti-malarial drug Eurartesim    after registration for its wide    use in    four African countries    namely    Mozambique, Tanzania,    Ghana    and    Burkina    Faso.

Q: What are some of the key findings in the Eurartesim trial under the various modules such as safety, cost effectiveness, provider and patient's compliance etc.?

R: In this study only safety and patient compliance was assessed. Preliminary results indicate that the drug is    safe with less than 5% of all participants presenting adverse events. None of the events was causally related with the study drug.

The principal safety question was related to risk of cardio toxicity. The study    has shown that although a slightly increase on  duration of the QTc interval was observed, the electrocardiogram  (ECGs) returned to normal after 7 days of follow up. ECG records the electrical activity of the heart. A lengthened QT    interval is a marker for the potential of risk factor for sudden death. The increase observed was not clinically significant.

Q: What are some of the major contributions of the Eurartesim drug trial to the treatment ofmalaria in Africa?

R: Eurartesim is a new antimalarial safe and highly effective for treatment of    uncomplicated malaria. And with the commodity to be administered once a  day for three days, the drug will  definitely have a high  impact on malaria control and also in malaria    elimination plans.

Q: What were some of the challenges to rolling out this project?

R: The main challenge was the delay with registration of the drug in the country and the long process of ethical and regulatory clearance. The complexity of study procedures was also a huge challenge to the study team.

Q: What were some ofthe key issues and hindrances to the effective treatment of malaria identified by the INESS project?

R: There were many hindrances, but the    key ones include the overload of the health facility in malaria high season, lack of qualified personnel, the lack of diagnosis    due to stock-out of the     rapid diagnostic test and absence  of microscopy in most of the    facilities, stock-outs of the drugs, and inefficient referral procedures.

Q: What is the cost of the Eurartesim drug?

R: The manufacturer price is €0.13. To calculate the local price, one has to add the transport, customs and internal taxes.

Q: What are the front line drugs for malaria in your country? Will the Eurartesim drug be added?

R: The first line treatment in Mozambique is Artemether-lumefantrine and the alternative to the first-line is Amodiaquine-Artesunate. Eurartesim could  be added to these lines    when all the data    produced by our study have been    analyzed and the safety    profile    of the drug is confirmed.

Q: Has there been any engagement with policy makers for its integration formally into the health system and incorporation into the malaria treatment policy?

R: This discussion started at the time of drug registration. The need for more information on safety was part of the discussions and it was agreed that the results of this study will be crucial    for the    decision making    process.

Q: What next after the Eurartesim trial in yoursite?

R: The INESS platform has created a network of centres and researchers trained and well    prepared to implement Phase 4 studies in Africa. Our site will    be happy to be involved in other similar  studies to assess the safety of    new anti-malarial drugs. At this time, the team    is analysing and writing up the data collected in this study to    share the results with all interested in this trial.

Q: What would you say are the legacies of the INESS project to Africa?

R: The INESS project have shown that African research centres can work together    to answer research questions of    specific interest to African communities.

Q: What has been your personal experience working on the INESS project?

R: The complexity of the project and the need to follow very high levels of accuracy to meet the European Medicines Agency (EMA) regulation was an odd training experience. The  team is now prepared to implement phase 4 trials.

Q: Any advice to government on the use of malaria drugs and treatment in your country?

R: Government must train health professionals in quick case identification and appropriate management. Drugs should be made available at health facilities to avoid stock-outs. There  should be improvement in malaria diagnosis and  the referral procedures.

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