Reasons For New Malaria Drugs Failing To Cure

Incidence of new types malaria medications failing to deliver the desired cure is rising among Nigerians. However, malaria experts have said such failures might be due to improper knowledge on how the medicines work.
Many Nigerians have complained of the inability of drugs regimens, including some of the Artemisinin based Combination Therapies (ACTs) to cure them of malaria, prompting concerns from the Federal Ministry of Health.

Although an inquest to authenticate these claims have been commissioned in Nigeria, experts and administrators of malaria programmes in Nigeria who spoke to Daily Independent say most Nigerians are not knowledgeable on what could make these medicines work optimally.

Manager of World Bank's Roll Back Malaria programme in Nigeria, Dr. Samuel Oyeniyi, said most of the medicines work best under certain PH level, and that some kind of food reduces the efficacy, especially of ACTs.

"ACTs cannot be very effective if taken with sodas (soft drinks) alone, just as a certain level of acidity (PH) is required for it to work well for individuals suffering uncomplicated malaria," Oyeniyi said.

He also said that most ACTs are very effective when taken after the malaria patient eats fatty foods, adding, however, that most failures are the result of wrong combination of anti-malarials.

"If you take ACTs with just a bottle of coke or cup of tea, it might not work as desired because the drug requires fats to work effectively. So it is usually advisable that malaria patients take some measure of fatty foods before taking the medicines," Oyeniyi said.

He also pointed out that the absence of malaria parasite in tested blood samples of some people might not mean they are free of the disease.

"That you have not come down with malaria does not mean you are free of it. Some times the parasites have the ability to lodge in the brain and other sensitive organs like kidney and liver unnoticed. Regular test cannot unearth their presence, hence it is very important that people take malaria parasite density test to avoid calamities," he said.

According to him, most drugs in use do not have the ability to reach for those parasites that are lodged in these organs, a reason the result is usually fatal when people with these cases come down with malaria.

"We've seen cases where people are brought to the hospital with untraceable causes of their condition. Some of them end up dying after which it is discovered that they have a huge lodgement of malaria parasites in their brains and other sensitive organs," Oyeniyi said.

Meanwhile, complaints about available malaria drugs not working has not gone down unnoticed. Already, the National Malaria Control Programme (NMCP) of the Federal Ministry Of Health has established sentinel sites across the country to monitor the efficacy of the drugs currently being used to treat malaria in the country. These are located in Kaduna, kano, Abia, Plateau, Imom Borno, Lagos, Anambra, Oyo, Kwara, and Enugu states.

Also, a shipment of 20 million pieces of rapid diagnostic tools for malaria diagnosis is on its way to Nigeria, the national coordinator of NMCP, Dr. Babajide Coker, has confirmed.

Although Coker said initial reports does not conform to the series of anecdotal reports of failure, the government is trying to be proactive to avoid been taken aback.

The diagnostic tools, according to Coker, would be distributed among doctors, across the country as a way of bridging the gap in malaria treatment. He said tools do not require electricity supply to work, hence cutting the power barrier that tends to affect results from laboratories in the country.

He also disclosed that the various test sites have began collating reports on efficacy of the malaria medicines (mostly ACTs) that would be made public in a latter date.

In Nigeria, there is a growing concern about the ability of ACTs in the market to effectively cure people of malaria. This has led to dampen confidence among a large proportion of the population just as evidence shows the malaria is unrelenting in the level of devastation it causes.

Information made available to the NMCP by one of the principal recipients of the Global Funds show that drug importers and local marketers have seen malaria medicines, especially the ACTs, as another avenue for making huge profits. This has led to the influx of hundreds of brands of the ACTs class of drugs in the country, some with questionable qualities.

Recent surveys have shown that there are no less than 54 brands of malaria drugs currently being sold in Nigeria for about N600 and above. Interestingly, most of the medicines are certified safe for consumption by the National Agency for Food and Drug Administration and Control (NAFDAC).

Only recently, a survey of malaria drugs in three African countries found that the anti-malaria drugs sold there are of poor quality. The joint U.S. and World Health Organisation (WHO) study found that up to 40 percent of artemisinin-based drugs in Senegal, Madagascar, and Uganda, failed quality tests.

Researchers found that between 26 and 44 percent of the malaria pills tested were low quality. Some of the problems found with these drugs included impurities or pills not containing enough active ingredient.

Malaria is caused by parasites that are transmitted to people through the bites of infected mosquitoes. It can be fatal but, experts say it is preventable and curable.

The WHO says the best available treatment is a combination of drugs known as artemisinin-based combination therapies. However, the discovery of low quality supplies of the drugs in the countries has given real cause for concern.

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