The Kenyan Ministry of Health is investigating two drugs used to treat malaria in hospitals to see if they are still effective.
The study of therapeutic efficacy against malaria started in March 2021 in the districts of Siaya and Bungoma in western Kenya. The study evaluated whether the first-line drug for uncomplicated malaria (artemether lumefantrine, AL) and the second-line drug (dihydroartemisinin-piperaquine, DHP) were still effective.
In the studies, clinicians rated how patients with uncomplicated malaria Patients with malaria respond to treatment by monitoring and analyzing their blood for the presence and amount of parasites. The last study in Kenya was conducted in 2016.
George Githuka, the department head of the National Malaria Program (DNMP), said the country is following the World Health Organization’s (WHO) recommendation for governments to carry out every two years therapeutic studies.
No records of resistance
Dr. Githuka said Kenya has not yet recorded resistance. However, scientists in other parts of the world have found that antimalarial drugs are becoming less effective.
“Kenya has been using artemether lumefantrine and dihydroartemisinin piperaquine to treat malaria since 2006. We are continuing to monitor to ensure that the drugs we use are effective,” he said.
Maureen Mabiria, a technical advisor and physician at PMI-Impact Malaria, said they chose the timing and location for the blood sampling.< /p>< p>“We selected Siaya County because of the high drug pressure, where a person can have four to six malaria infections in a year and would receive antimalarial drugs,” said Dr. Mabiria.
< p>Bungoma has a low drug pressure where people get fewer than two bouts of infection in a year.
Whenever a person gets malaria, a blood test would show the presence of parasites show in the blood.
Dr. Mabiria said an effective antimalarial drug would eliminate the parasites in the blood; ineffective drugs to which the parasite has developed resistance would not do so.
However, a patient presenting with the presence of parasites after treatment does not automatically mean resistance exists.
“The artemether lumefantrine stays in the body for about 28 days, but patients leave the hospital and get bitten by mosquitoes and become infected again,” said Dr. Mabiria.
She said it was important to know if the parasites found in the blood a few weeks after treatment are due to a new infection or if the antimalarial drug has not eliminated them due to resistance.
From other parts of the world, such as B. Southeast Asia, first cases were reported showing signs of resistance to artemisinin in the early 2000s.
In a very short time, some of the most effective antimalarial drugs in the region became useless, putting millions of people at risk.
Kenya Malaria Indicator Survey (KMIS) 2020, launched in April 2021, showed that the country has made significant progress towards elucidating its prevalence.
The WHO has sounded the alarm about drug resistance in Africa. Scientists reported the existence of resistance-related gene mutations in malaria parasites in Rwanda between 2012 and 2015.
A September 2021 study published in the New England Journal of Medicine showed that; such mutations cause a marked decline in the ability of antimalarials to quickly treat people with the disease in Uganda.
Majority of cases
According to the World Malaria Report, Africa accounted for 94 percent of malaria cases Malaria cases and deaths in 2019.
Dickson Mwakangalu, public health expert at John Hopkins subsidiary Jhpiego and senior scientist in Kenya at PMI Impact Malaria, said: “The results of this study will lead Kenya to know if the drug is still working or the country needs to look for alternative drugs for malaria.”
Kenya’s Health Ministry said it has concerns about activities that could render the drugs useless.
Dr. Githuka said health workers and the public are flaunting guidelines for taking antimalarial drugs and using them for fevers, headaches or chills. He said these are common symptoms of any infectious disease, not just malaria.
A microscopic test is required to confirm the presence of malaria pa Rasites. However, many healthcare facilities do not have working microscopes.
In addition, healthcare facilities with microscopes may lack qualified laboratory personnel to perform the test.
Dr. Githuka added that they are counterfeit and substandard antimalarial drugs. Drugs contain no active ingredients or less than the amount required to treat malaria.