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Prophylaxis doses can reduce malaria deaths, re-admission in children-Study

Masaka Regional Referral hospital, one of the hospitals where the study took place

Kampala, Uganda |  THE INDEPENDENT | A new study has revealed that if children are given a prophylaxis malaria dose for three months after they are discharged, the number of malaria-related deaths or re-admissions are reduced up to 70 percent. 

A total of 1,049 children under the age of five took part in the study that was published in the New England Journal of Medicine.  All enrolled children were mildly anaemic. 524 of them were given an antimalarial of the drug while 525 were given a placebo.     

The study took place in nine hospitals located in Kenya, Uganda and Tanzania. In Uganda, five hospitals- Jinja hospital, Masaka Regional Referral hospital, Mubende hospital, Hoima hospital and Kamuli Missionary hospital participated in the study. The study was carried out by scientists at Makerere University.

Children who took part in the study were either given a dose of Dihydroartemisinin-piperaquine or a placebo for three months after they were discharged from the hospital. Each month the children swallowed nine tablets for three days.  Findings from the study show that children who received the drug faced reduced rates of death or even re-admission into the hospital by 72 percent.

Data from the study shows that anti-malarials can reduce the rate of death in children with severe anaemia caused by malaria by 92 percent. The medication also reduced the chance of re-admission for malaria by 69 percent. Out of the 524 who got the drug, only one child died while 18 deaths were reported among those who got the placebo.     

Dr Richard Idro, the principal investigator on the study says the findings show that the prophylaxis treatment when given to children at discharge is effective in reducing malaria-related complications.

“Children have been leaving hospital only to return after two weeks with another bout of malaria and we have been wondering what might be the cause for this. But now we know that there is a way to prevent deaths and re-admissions that occur after discharge from happening,” he said. 

Dr Jimmy Opigo, the head of the malaria control programme at the ministry of health said the findings from the study were exciting. He said they will be a game-changer in reducing the number of malaria-related deaths.   

“We have been concentrating on prevention and treatment to handle malaria but the moment the children left hospitals after receiving treatment and even blood transfusions, they would go back after two weeks. Sick again. We did not know why this was or how it could be avoided. But now we know and we are going to deal with the problem,” he said.   

Last year, over 12,000 children in Uganda succumbed to malaria. Annually, over 25 percent of all collected blood by the Uganda Blood Transfusion Services.   

Dr Idro says they were pushed to carry out a local study after colleagues in Malawi carried out a similar study but on small scale and realized that chemoprevention could reduce the number of malaria-related deaths.

While the study shows a lot of promise, the cost-effectiveness of it might be a hindering block. On average the government spends 5,000 Shillings to procure a dose of antimalarial currently. 

If the government adopts the new malaria preventive method, it will have to spend three times more than it does. For three months, they will have to spend between 15,000 to 30,000 Shillings to just buy the drug without incurring transport costs.



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