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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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  • Volume 1

Stumbling blocks

The mere colour or packaging of a malaria drug can determine whether a patient will take the drug or not, which can affect the bigger picture of how effectively malaria is managed.

Other issues such as access to and cost of drugs, and how health providers comply with acceptable treatment of malaria are important determinants in a patient’s full recovery from a bout of malaria attacks.

Some findings show that if about a 1000 patients sought treatment for malaria, only about 80 of them will end up being treated satisfactorily.

This is because despite the inception of anti-malarial drugs into the health system, and the efforts at malaria prevention, there is still more work to be done as malaria diagnosis and treatment plus other social factors affect the efficacy of the drugs and how effectively a patient gets treated.

These are some of the concerns that the INDEPTH Effectiveness and Safety Study (INESS), a Phase 4 project, seeks to address by assessing the effectiveness of new malaria treatments and its determinants in real life setting in Africa and within health systems to improve upon the management of malaria 

Dr. Frank Atuguba, INESS Coordinator at the Navrongo Health Research Centre (NHRC), in an interview in Navrongo, said the project has been divided into several mini projects called modules to help the health sector identify these problems and tackle them.

He cited impediments in accessing health facilities, diagnoses problems, and other social factors that prevent the accurate intake of malaria medication as forming part of the health system factors that hinder efficacy even if the drug is over 95% efficacious.

He said the Access module looks at the financial, geographical, or socio-cultural issues that prevent a person from actually accessing a health facility that provides anti-malarial drugs, in this case an artesunate-amodiaquine (ACTs), in a timely fashion. There is also the Diagnostic, Targeting and Compliance model that look at what happens at the health facility; whether the appropriate tests are conducted and whether the right anti-malarial drugs are prescribed.

According to Dr.Atuguba, after the prescription stage, there is the need to follow up on the patient to find out whether the person is taking the medication as instructed and the Adherence Module takes care of that.

There is also the Safety Module which looks at the adverse events that are associated with taking the medication.

 He said that patients who have taken these anti-malarial drugs are followed up by selected individuals from the chosen health facilities to inquire about the side effects or the adverse events that they have experienced after taking these anti-malarial drugs.

INESS, additionally, has the Efficacy Module that looks at the action of the medication or the anti-malarial in research mode because it may differ from what happens in true life. This model finds out whether what happens in true life has any effect from its real effect if all the surrounding factors are taken off.

There is also the acceptability component which looks at the socio-cultural factors that could prevent a patient from taking an anti-malarial drug correctly.  

He said other soft factors may hinder drug efficacy because health systems work in certain milieus which may differ from district to district or from country to country and are determined by the Contextual Model.

Dr.Atuguba said that all the outlined models help INESS to tell what problems are hindering the effectiveness of any anti-malarial drug and consequently slowing down malaria management.

He noted that the study started with the Access Module in 2009 and subsequently the other models were introduced. Except for the Cohort Event Monitoring under the Safety Module that is still running, all other models have ended.

- By  Mavis Tetteh - Ghana


Iness Edition