Malaria has bedeviled humans for centuries, as the killer parasite that causes the disease has an uncanny ability to adapt and become resistant to medicines. To make matters worse, without appropriate test kits, strong anti-malaria drugs might be prescribed for patients that don’t need them or aren’t actually sick, which can also create strains of the disease that are resistant to treatment.
Yet it only takes a few euros to purchase appropriate medicine and tests to beat resistance and save lives. In the Kigoma region of Tanzania, the Red Cross has been using the most powerful malaria treatments, known as artemisinin-based combination therapies (ACTs) and quality-assured “rapid diagnostic” tests for thousands of children. As part of our ongoing “Ninos Sin Malaria” campaign with the Red Cross in Spain, we spoke with Dr. Ernest Athumani, the local Health Coordinator in Kigoma, about his organization’s achievements and how only six euros can save lives.
According to Dr. Ernest, before the introduction of ACT and rapid diagnostic kits, up to 60% of patients in the region had developed resistance to the previously-used drug, known as SP (Sulphadoxine with Pyremethamine). ACT was introduced in 2006 and the results have been impressive. Dr. Ernest told us:
There has been a decrease in deaths caused by malaria compared to the time before the introduction of ACT despite the increase of population in the region from 574,580 in 2006 to 657,320 in 2009. [due to an influx of refugees] The under-five mortality has significantly reduced, but as always, they are the most affected by the disease.
In Kigoma, Plasmodium falciparum, the most deadly of the malarial parasites, strikes fast, sometimes killing children before they can reach a cure. Rapid diagnosis and appropriate treatment is essential once the parasite is transmitted by mosquito bite. In the region, the Red Cross provides treatment for more than 100,000 people, many of them refugees from neighboring Congo and Burundi. The numbers show just how common and virulent the disease is, according to Dr. Ernest:
In the year 2006 the incidence of malaria in Kigoma District stood at 205 cases per 1000. There were a total of 118,289 malaria cases treated, with 72,256 cases being children under five years old. This was before the introduction of ACT. A total of 90 deaths were reported in 2006, with 69 among the under five. Currently the incidences of falciparum malaria stand at 221 per 1000. In 2009 out of 151,488 cases of falciparum malaria reported 87,068 cases were children. A total of 70 deaths were reported due to malaria, 51 were young children.
The use of ACT medication has certainly saved lives and importantly, has beat resistance. According to Dr. Ernest there are no scientifically proven incidences of resistance of falciparum against the new ACT drug reported so far in the camps.
But the battle against resistance hinges not just on the drugs – the tests count just as much. According to the World Health Organization’s recent World Malaria Report 2010, the increased use of inexpensive “rapid diagnosis tests” in sub-Saharan Africa has cut down on the over-prescribing of ACTs, and has greatly cut back on resistance. Before these tests, patients with just a simple fever were often given ACTs, which can build up resistance in the patient.
Now, health workers can use the rapid diagnostic tests to quickly identify the source of a fever in a young child. Dr. Ernest explains:
If a child below five years-old presents symptoms of malaria, they will undergo a rapid diagnostic test. If this test is positive and the child shows symptoms of uncomplicated malaria, they will be given ACT treatment. If they have a complicated form of malaria, they will undergo a course of intravenous quinine. If the rapid diagnosis test is negative, other causes will have to be ruled out. Afterwards, if no other causes for the malaria-like symptoms are found, the child will be given ACT and put under observation.
This combination of powerful new drugs and rapid tests makes up what the Red Cross calls their “Malaria Management Protocol,” and it has saved countless lives in Kigoma. Yet programs like this are proving their worth around the world, often with international funding and local specialists like Dr. Ernest working hand-in-hand.
Yet funding challenges remain and that is where you can help by donating through Ninos Sin Malaria. Dr. Ernest finished our conversation with a warning:
The new malaria protocol – rapid diagnosis test and treatment – has worked and reduced the number of infected people But we are now seeing stock outs of the drugs in the Kigoma region – this could reverse the successes achieved.