Fruity treatment for malaria

A refugee child in a displaced persons
camp in Lira, Uganda, holds her new
insecticide-treated mosquito net.
(Image: President’s Malaria Initiative)

Janine Erasmus

A fruit-flavoured dispersible anti-malarial treatment developed by Swiss drug giant Novartis AG offers new hope to millions of children suffering from malaria.

A study was carried out in Benin, Kenya, Mali, Mozambique, and Tanzania on 899 children suffering from Plasmodium falciparum malaria, the most severe kind, but without complications. Resistance to conventional anti-malarial drugs is high in these areas.

Up till now the standard malaria treatment for young children has been to crush a tablet and administer it in water, but the taste is very bitter and unpleasant and is often rejected. Crushing is also an inefficient technique that increases the risk of reducing the dosage, according to researcher Issaka Sagara of the Malaria Research and Training Centre at the University of Bamako in Mali.

Additionally, swallowing only a portion of the recommended dosage increases the possibility of drug-resistant strains of the parasite developing.

Under the leadership of Dr Salim Abdulla of the Ifakara Health Institute in Dar es Salaam, Tanzania, doctors randomly selected 452 children for the crushed tablet treatment and 447 for the dispersible formulation treatment. Both forms of the drug contain 20mg artemether and 120mg lumefantrine as active ingredients.

Designed exclusively for the most vulnerable victims, children up to 12 years of age, the new medication dissolves quickly in a small amount of water. It is expected to make it much easier for tots to complete a course of treatment, an essential component of full recovery.

Promising results

After 28 days 97.8% of children on dispersible medication were cured versus 98.5% on the conventional treatment. The conclusion of the study, which was published in renowned medical journal The Lancet in October 2008, was that a six-dose course of the medication was as effective as the current regime, and has a similar safety profile.

The 28-day cut-off period as opposed to only six days of treatment is to accommodate the longer half-life in the blood of lumefantrine, a characteristic that is said to substantially prevent new infections.

The treatment could also delay the development of drug resistance, according to Dr Awash Teklehaimanot of Columbia University’s Earth Institute, and Dr Haily Desta Teklehaimanot of Addis Ababa Center for National Health Development in Ethiopia.

Novartis plans to launch the treatment, which is currently under review by regulatory authorities, in affected countries in early 2009. It currently distributes the conventional version of the drug widely in Africa, and has provided millions of regular treatment courses throughout the continent on a non-profit basis, helping to save some 500 000 lives.

Researcher Bernhards Ogutu, of the Kenya Medical Research Institute, says it is extremely important to have child-friendly medication because in areas where malaria is highly prevalent little ones may need treatment two or three times a year.

Earlier in 2008 Novartis was a partner in the two-month Roll Back Malaria Zambezi Expedition, where participants traversed the entire 2 500km length of the mighty Zambezi River in Southern Africa, from its source in north-west Zambia to its delta in Mozambique. Along the way they crossed six countries, mobilising communities, spreading the word about available treatments and preventive measures, and handing out mosquito nets and anti-malarial drugs.

A widespread killer

Malaria is transmitted by female Anopheles mosquitoes. Untreated, it is a killer disease that claims a child under the age of five every 30 seconds, according to the World Health Organisation. Almost half the world’s population – about 3.3-billion people – are at risk of contracting malaria. Malaria is widespread across most of Africa and most of the victims live in sub-Saharan Africa, the region hardest hit by the disease.

Malaria is both preventable and curable, but for youngsters the normal treatment is a bitter pill to swallow. Prevention of the disease is a priority for the World Health Organisation and other bodies because of the enormous impact it has on growth and development.

One bite from an infected mosquito can result in a long period of feverish illness, keeping children out of school and preventing adults from working to provide for their families. Malaria places a dreadful burden on the social and economic structures of developing nations and in financial terms it costs the African continent alone about $12-billion every year. In Africa it is recognised as a major contributor to poverty, as well as a symptom of it.

The United Nations, under its Millennium Development Goals programme, plans to have completely halted the spread of the disease by 2015, and even begun to reverse its incidence.

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