Ghanamedj.org

COMMENTARY
The Efficacy of Amodiaquine plus Artesunate Combination in Ghana
Prompt and effective treatment of malaria cases is a What should occupy us now is how to make this effec- goal desired by all as we await the imminent discovery tive treatment available to the population that needs it. of an effective vaccine made available to the popula- This is where implementing home management using tion at risk, especially the vulnerable groups. This de- AQ/AS combination is recommended. This recom- sired goal cannot be achieved without having available mendation is informed by the fact that varied factors efficacious medicines to treat acute infections. How- affect treatment seeking behaviour other than just hav- ever, coming to terms with the fact that the Plasmo- ing efficacious drug treatment available at facility lev- dium falciparum is a crafty parasite capable of devel- els. Some of these factors could be social, cultural, oping resistance to once effective anti malarial drugs economic and political and the national control pro- like chloroquine and SP, there is the need to constantly gramme must be at the forefront, as usual, to make this monitor both clinical and parasitological responses to possible. The desired effect of this treatment on mor- the currently available medicines. It is for this reason bidity and mortality as well as prevalence level cannot that the National Malaria Control programme has insti- be achieved without the treatment being made available tuted the monitoring of the efficacy of artemisinin to the majority of those who need them.
combination therapy (ACT), particularly Amo-diaquine+Artesunate combination (AQ/AS), in Ghana. Collins Ahorlu PhD
This combination was the first ACT to be recom- mended for the treatment of uncomplicated malaria in Noguchi Memorial Institute for Medical Research In this issue of the journal, Koram et al (page 55) re- E-mail: [email protected]
port findings on the efficacy of AQ/AS combination for the treatment of uncomplicated malaria in children Conflict of Interest: None declared
under five years. The choice of this age group is appro-priate since about 90% of malaria cases in Ghana, aselsewhere in sub-Saharan Africa, occur in this age group. The authors established from their preliminary report that AQ/AS combination therapy, resulted in rapid, high clinical and parasitological cure rates in children in the first full year of implementation of the uncomplicated malaria treatment policy. They have shown with data that almost all children monitored (99.8%) had cleared their parasitaemia by Day 3 and the cure rates remained at more than 90% throughout the 28 days of follow up. Perhaps, the good news was that the treatment was effective at all the study sites, which represented all the three ecological zones of Ghana, and did not differ by gender. With this evidence, policy makers and the general pub-lic should not be discouraged by the numerous com-plaints that have bedevilled the introduction of this highly effective treatment for uncomplicated malaria in Ghana. This effort to provide evidence-based informa-tion to both prescribers and consumers should con-tinue. The national malaria control programme also needs to monitor the implementation process in addi-tion to the drug efficacy in order to constantly and in-novatively address implementation challenges to en-hance acceptability of the drugs by the population.

Source: http://www.ghanamedj.org/articles/June2008/Commentary.pdf