28 AUGUST 2018 • 11:48 AM
The number of children dying from malaria has been
dramatically cut with the introduction of a new drug and bicycle transport to
hospital.
In a pilot project in the Serenje district of Zambia,
children with suspected severe malaria were given the drug rectal artesunate
(RAS) and then transported to a health facility for further treatment.
The combination of the drug and prompt referral cut death
rates by 96 per cent, compared to the previous year when the drugs and
transport were not available.
During the year-long project just three children died,
compared to the 97 that would have been normally expected to die among the
1,215 children that contracted severe malaria during the 12-month period.
Normally 8 per cent of children die from the disease in the
district and that was cut to 0.25 per cent during the project.
The majority of deaths from malaria are among children and
it is the biggest killer of the under fives in sub Saharan Africa. The most up
to date figures show that 300,000 children died from the disease out of a total of
446,000 in 2016.
RAS was first recommended as an emergency treatment for
malaria by the World Health Organization more than 10 years ago but there was
no approved medicine available until late last year.
During the project, run by Medicines for Malaria Venture,
transport charity Transaid and the Zambian National Malaria Elimination Centre,
500 community health volunteers were trained to teach parents about the signs
of malaria and administer the malaria drug. Emergency transport riders were
also employed to take children to hospital on trailers attached to bikes.
RAS on its own will not save lives but it buys vital time,
giving children around 12 hours to get to a health facility - this is crucial
in rural areas where health facilities are sparsely located or are difficult to
get to.
Another key aspect of the project was ensuring that health
facilities had the injectable form of the malaria drug
artesunate and 31 health workers were trained to administer this.
Pierre Hugo, senior director for access and product
development at Medicines for Malaria Venture, said that giving RAS on its own
would not have saved children’s lives.
“Before the project patients weren’t being referred to
health facilities or they were being referred or not going because they didn’t
have the money or the means to get there,” he said.
Now the sick child and their mother or father are put in
a trailer
attached to a bicycle and taken to a health facility. The last stage
of the journey was previously known as the killing mile because of the number
of children who died before they could get life-saving treatment.
Mr Hugo added: “The project has been successful because we
had the drug available, had trained healthcare workers, had someone to get them
to the facility and, crucially, the health facility had injectable artesunate.”
He said that three more districts in Zambia were working
with the government to implement the project which, he said, was replicable
in other countries. “The drug has been procured by other countries so that’s
really encouraging.
"In fragile states and countries with poor public
health infrastructure this is the ideal drug because it gives a much better
survival rate by buying that extra time until a patient can get to a health
facility,” he said.
Caroline Barber, CEO of Transaid, said: “The number of lives
saved is a real testament to how important timely access to healthcare services
is and we’re delighted to be able to share such excellent results and are now
looking at how this approach can be scaled up across Zambia.”
Joseph
Ana
AFRICA
CENTRE FOR CLINICAL GOVERNANCE RESEARCH & PATIENT SAFETY
@Health Resources
International (HRI) WA.
National Implementing Organisation: 12-Pillar Clinical Governance
National Implementing Organisation: PACK Nigeria Programme for PHC
Publisher: Medical and Health Journals; Books and Periodicals.
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Joseph Ana has a cumulative continuous practice experience of over 40-years in
Nigeria, United Kingdom and Ghana as a Primary Health Care Physician, Public
Health Expert, General and Urological Surgeon, Health Policy Expert and
Implementer, Medical Educator and Trainer..
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