In the 2000 World Health Organization (WHO) report it was stated that Malaria affects 300 to 500 million people every year across the world and is one of the leading cause of illness and death in the sub-Saharan African countries. A new study conducted by Dr. Hasifa Bukirwa of the Uganda Malaria Surveillance Project and Julia Critchley of the Liverpool School of Tropical Medicine in England stated that older drugs showed better efficiency when used in the treatment of malaria in some parts of Africa.
The older drug is a combination of sulfadoxine-pyrimethamine (Fansidar) and amodiaquine. The new drug is a combination of Fansidar and artesunate. The researchers analyzed four studies including 775 malaria patients children age six months to five years and compared the Fansidar-amodiaquine treatment to Fansidar-artesunate therapy for mild to moderate cases of falciparum malaria.After 28 days of treatment, there was a reduction (40%) in the number of cases of malaria among children who were taking a combination of the older sulfadoxine-pyrimethamine and amodiaquine than among patients taking a combination of Fansidar and artesunate (artemisinin).
But the new drug combination Fansidar-artesunate was more than twice as effective in clearing malarial parasites from the blood at a particularly stage of parasite development than the older drug combination. This step is important to prevent the spread of the disease. Hence the researcher feels that the older combination can be used to treat patient who have not developed resistance to the older drug combination and who lack access to the new drugs.
The results of the study are published in current issue of The Cochrane Library. The latest combination drug Artemisinin is very effective against multi-drug resistant strains of the falciparum type of malaria.
Artemisinin are not widely available in some of the African countries due to the low production, high cost, dosing complexity and the lack of clinical experience with artemisinin-based combinations.
Dr. David Bell, a malaria expert at the University of Liverpool in England said that in places where malaria is a major public health problem the old combination Fansidar-amodiaquine is not the treatment of choice.
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