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ANNOUNCEMENTS:::

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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Thumps up for Eurartesim!

Dr Seth Owusu-Agyei, Director of the Kintampo Health Research Centre (KHRC) says the new anti-malarial drug, eurartesim, is good to go.

“We have established that the eurartesim drug works in the Ghanaian context and    has few side effects just like the other anti-malarials like artesunate-amodiaquine (AA) and artemether lumefantrine (ALu).”

The drug belongs to the dihydro-artemisinin piperaquine phosphate (DHAP) group of drugs and is registered in Ghana just like the AA and ALu drugs, as  a first line treatment drug for simple malaria.

The Director, speaking to the AMMREN team who visited Kintampo, said eurartesim can   easily  be accepted  and integrated into the malaria control policy.

The trial to assess the safety of the eurartesim drug at the site began in October 2013    to March 2014, as part of the INESS project to inform policies in Africa related to post-registered  artemisinin-based combination therapies    (ACTs).    

Dr Owusu-Agyei, who gave some history about the INESS project and background information on the eurartesim study, said: “We tested coartem (a brand of artemether-lumefantrine) and artesunate -amodiaquine and the experience we had was that they   were okay and efficacious if taken well.    

He said usually after introduction of drugs such as ALu    and AA into the    health system, compliance issues reduced their  effectiveness because when a drug can even cure    they can be made  impotent by not  complying to their usage.

“We tested eurartesim, and it is already on the market as dihydro-rtemisinin-piperaquine, to see how it works in the Ghanaian market. Its side effect is not very different from what we got from artesunate amodiaquine and artemether lumefantrine.”

Dr Owusu-Agyei said “for a research centre renowned for malaria  study, the eurartesim study is one of the many studies carried out. We are interested in new anti-malarials that are good enough for registration and we will be happy to assess them to give policy directions.”    

He expressed concerns about the abuse of anti-malarials, saying, we do not have too many ACTs so, we need to guard against the  abuse of the new drugs  we have, so we   do not lose them too soon as previous drugs.
Dr Kwaku Poku Asante, Head of Research at KHRC and the PI for the eurartesim study, said the KHRC had done some studies on anti-malarials in the past, which had informed policy and held discussions with the National Malaria Control Programme (NMCP) in replacing chloroquine. We have done some  research in chloroquine study which helped the change over to artesunate-modiaquine.”

He said the centre had also conducted various studies including one on artesunate-amodiaquine drug compliance, provider behavior and side effects. These studies, he said, helped the NMCP to review their messages to get people to    accept the drug. The centre also trained chemical sellers to use the rapid diagnostic test kits to test before selling anti-malarials to clients.        

He mentioned community management of malaria and said it is necessary to track   patients after treatment to see if they are doing well and if not, to assist them. “Patients will typically visit a licensed chemical seller but after treatment, who tracks the patients to ensure that the person is cured and has no side effects. We need to strengthen the community management of malaria. After the licensed chemical seller treats does the person get well? And if the person does not get well what do they do? If the burden of malaria goes down  other diseases will emerge.”

Mr Anthony Kwarteng, the INESS Project Coordinator at KHRC, said the whole of the INESS study was to assess if drugs introduced into the market after licensure are serving the purpose for which they were introduced.            

He said the Kintampo field staff and study team of about 60 undertook the eurartesim trial with a team made up of researchers, field officers, clinicians, laboratory and data entry   staff. “About  1,830 study participants, aged between 6 month to adults, were recruited and subjected to laboratory tests and monitored for adverse drug reactions after taking the drug”.

Mr Kwarteng said the Kintampo site provided almost a fifth of the 10,000 study participants recruited into the study across the four countries, namely, Ghana, Tanzania, Mozambique and Burkina Faso - which took part in the study. “It was a multi-centre and multi-study project with a primary purpose of making the drug safe and effective,” he explained.

He said there were some production challenges from the manufacturers of the eurartesim drug in getting it into the country and this posed a problem because the site had already recruited and trained personnel for the study and    the delay was costly.    

Dr Abena Konadu Yawson, a Senior Medical Officer at the Kintampo Municipal Hospital and  Clinical Research Fellow, who served as  a clinician in the eurartesim study, said the drug is good in terms of adherence as it is easy to use, with fewer tablets to take and also the fact that “they come in small packages and in  three days you have completed the dose.”

On some advice on malaria treatment, she said during this study, “we tested everybody we treated with eurartesim for malaria and we realized that not all the people we tested with RDT had malaria, it was not up to 100 per cent or even 70 percent.”

One of the lab equipment used in the study at KHRC She said there was the need to make RDTs available to the sub-district level and measures must be established to make sure it was used because some health workers still presume they can diagnose malaria when they see the symptoms without verifying clinically.

“There is the need to test before treatment right down to the districts, sub-districts and at the lowest levels.”

Mr David Dosoo, Laboratory Manager of KHRC, said the test on the blood samples    collected were taken through haemato-logical analysis through the use of an haematology analyser for measuring blood levels and to assess the impact of eurartesim on the blood levels of the study participants, including, haemoglobin levels, the red blood cell count, white blood cell count platelets.

Mr. Dosoo said a biochemistry analyser was also used for assessing organs, adding that the INESS project donated an Easy lite Electrolyte Analyser for assessing the kidney function of the study participants.

He said the study also went through external quality assessment to ensure that laboratory standards were maintained with support from the National Institute for Communicable Diseases in South Africa for malaria external quality assessment and the College of American Pathologists.
 

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