Artemisinin combination therapies ie ACTs have been found to be almost equally effective in reducing transmission of malaria as insecticide-treated bednets, or ITNs, in areas of low transmission; a new study has revealed.
Researchers from the London School of Hygiene and Tropical Medicine, with colleagues from Imperial College, London and Radboud University in Nijmegen in the Netherlands used mathematical modeling to predict the potential impact on transmission outcomes of introducing ACT as the first-line treatment for uncomplicated malaria in six areas of Tanzania.
The effects of ACT were estimated from clinical trial data.
The researchers found that the reductions in infection and clinical episodes of malaria were predicted to be highest in areas of low transmission, where it was estimated that a 53 percent decrease in clinical episodes might occur if all current treatments were switched to ACT.
This compared to 21 percent in the areas with the highest transmission.
"Overall, we predict that at existing treatment rates, a 100 percent switch to ACT from non-artemisinin drugs could reduce the rate of clinical episodes of malaria by between 21 and 53 percent if a short-acting ACT such as artemether-lumefantrine was used," Lucy Okell, Research Degree Student at the London School of Hygiene and Tropical Medicine and lead author of the study, said.
"The impact is smallest in the highest transmission settings, but it could be up to three times greater in these areas if a long-acting ACT regimen was used. As endemic countries gear up for malaria eradication, a target called for by the Bill and Melinda Gates Foundation in 2007, it will be important to know how choice of first-line treatment can help reach this goal," Okell added.
The study is published in the journal PLoS Medicine.