Your search found 150 Results

  1. 1
    375900

    2016 WHO Antenatal Care Guidelines. Malaria in pregnancy frequently asked questions (FAQ).

    Maternal and Child Survival Program [MCSP]

    [Washington, D.C.], MCSP, 2018 Mar. 6 p.

    In 2016, the World Health Organization (WHO) published Recommendations on Antenatal Care for a Positive Pregnancy Experience (WHO 2016), which outlines a new set of evidence-based global guidelines on recommended content and scheduling for antenatal care (ANC). These recommendations are the first set of ANC guidelines created under WHO’s current approved process for development of clinical guidelines. This FAQ addresses commonly asked questions about the implementation of IPTp programs in the context of the 2016 ANC recommendations, as well as reminders about technical considerations for intermittent preventive treatment of malaria in pregnancy programs.
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  2. 2
    375892

    Prevention and control of malaria in pregnancy: reference manual. 3rd edition, 2018 update.

    JHPIEGO

    Baltimore, Maryland, Jhpiego, 2018. 92 p. (USAID Award No. HRN-A-00-98-00043-00; USAID Leader with Associates Cooperative Agreement No.GHS-A-00-04-00002-00)

    The Malaria in Pregnancy reference manual and clinical learning materials are intended for skilled providers who provide antenatal care, including midwives, nurses, clinical officers, and medical assistants. The clinical learning materials can be used to conduct a 2-day workshop designed to provide learners with the knowledge and skills needed to prevent, recognize, and treat malaria in pregnancy as they provide focused antenatal care services.
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  3. 3
    375796

    World malaria report 2017.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2017. 196 p.

    The World malaria report, published annually, provides a comprehensive update on global and regional malaria data and trends. The latest report, released on 29 November 2017, tracks investments in malaria programmes and research as well as progress across all intervention areas: prevention, diagnosis, treatment and surveillance. It also includes dedicated chapters on malaria elimination and on key threats in the fight against malaria. The report is based on information received from national malaria control programmes and other partners in endemic countries; most of the data presented is from 2016.
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  4. 4
    374727

    Implementing malaria in pregnancy programs in the context of World Health Organization recommendations on antenatal care for a positive pregnancy experience.

    Maternal and Child Survival Program [MCSP]

    [Washington, D.C.], MCSP, 2017 Apr. 6 p.

    This technical brief highlights recommendations for the prevention and treatment of malaria in pregnancy (MiP) in the context of the World Health Organization (WHO) Recommendations on Antenatal Care for a Positive Pregnancy Experience, published in 2016. Also available in French and Portuguese.
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  5. 5
    390356
    Peer Reviewed

    The relative roles of ANC and EPI in the continuous distribution of LLINs: a qualitative study in four countries.

    Theiss-Nyland K; Kone D; Karema C; Ejersa W; Webster J; Lines J

    Health Policy and Planning. 2017 May 1; 32(4):467-475.

    Background: The continuous distribution of long-lasting insecticidal nets (LLINs) for malaria prevention, through the antenatal care (ANC) and the Expanded Programme on Immunizations (EPI), is recommended by the WHO to improve and maintain LLIN coverage. Despite these recommendations, little is known about the relative strengths and weaknesses of the ANC and EPI-based LLIN distribution. This study aimed to explore and compare the roles of the ANC and EPI for LLIN distribution in four African countries. Methods: In a qualitative evaluation of continuous distribution through the ANC and EPI, semi-structured, individual and group interviews were conducted in Kenya, Malawi, Mali, and Rwanda. Respondents included national, sub-national, and facility-level health staff, and were selected to capture a range of roles related to malaria, ANC and EPI programmes. Policies, guidelines, and data collection tools were reviewed as a means of triangulation to assess the structure of LLIN distribution, and the methods of data collection and reporting for malaria, ANC and EPI programmes. Results: In the four countries visited, distribution of LLINs was more effectively integrated through ANC than through EPI because of a) stronger linkages and involvement between malaria and reproductive health programmes, as compared to malaria and EPI, and b) more complete programme monitoring for ANC-based distribution, compared to EPI-based distribution. Conclusions: Opportunities for improving the distribution of LLINs through these channels exist, especially in the case of EPI. For both ANC and EPI, integrated distribution of LLINs has the potential to act as an incentive, improving the already strong coverage of both these essential services. The collection and reporting of data on LLINs distributed through the ANC and EPI can provide insight into the performance of LLIN distribution within these programmes. Greater attention to data collection and use, by both the global malaria community, and the integrated programmes, can improve this distribution channel strength and effectiveness.
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  6. 6
    377078
    Peer Reviewed

    Assessing the availability of LLINs for continuous distribution through routine antenatal care and the Expanded Programme on Immunizations in sub-Saharan Africa.

    Theiss-Nyland K; Lynch M; Lines J

    Malaria Journal. 2016 May 04; 15(1):255.

    BACKGROUND: In addition to mass distribution campaigns, the World Health Organization (WHO) recommends the continuous distribution of long-lasting insecticidal nets (LLINs) to all pregnant women attending antenatal care (ANC) and all infants attending the Expanded Programme on Immunization (EPI) services in countries implementing mosquito nets for malaria control. Countries report LLIN distribution data to the WHO annually. For this analysis, these data were used to assess policy and practice in implementing these recommendations and to compare the numbers of LLINs available through ANC and EPI services with the numbers of women and children attending these services. METHODS: For each reporting country in sub-Saharan Africa, the presence of a reported policy for LLIN distribution through ANC and EPI was reviewed. Prior to inclusion in the analysis the completeness of data was assessed in terms of the numbers of LLINs distributed through all channels (campaigns, EPI, ANC, other). For each country with adequate data, the numbers of LLINs reportedly distributed by national programmes to ANC was compared to the number of women reportedly attending ANC at least once; the ratio between these two numbers was used as an indicator of LLIN availability at ANC services. The same calculations were repeated for LLINs distributed through EPI to produce the corresponding LLIN availability through this distribution channel. RESULTS: Among 48 malaria-endemic countries in Africa, 33 malaria programmes reported adopting policies of ANC-based continuous distribution of LLINs, and 25 reported adopting policies of EPI-based distribution. Over a 3-year period through 2012, distribution through ANC accounted for 9 % of LLINs distributed, and LLINs distributed through EPI accounted for 4 %. The LLIN availability ratios achieved were 55 % through ANC and 34 % through EPI. For 38 country programmes reporting on LLIN distribution, data to calculate LLIN availability through ANC and EPI was available for 17 and 16, respectively. CONCLUSIONS: These continuous LLIN distribution channels appear to be under-utilized, especially EPI-based distribution. However, quality data from more countries are needed for consistent and reliable programme performance monitoring. A greater focus on routine data collection, monitoring and reporting on LLINs distributed through both ANC and EPI can provide insight into both strengths and weaknesses of continuous distribution, and improve the effectiveness of these delivery channels.
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  7. 7
    340984
    Peer Reviewed

    Global Call to Action: Maximize the public health impact of intermittent preventive treatment of malaria in pregnancy in sub-Saharan Africa.

    Chico RM; Dellicour S; Roman E; Mangiaterra V; Coleman J; Menendez C; Majeres-Lugand M; Webster J; Hill J

    Malaria Journal. 2015; 14:207.

    Intermittent preventive treatment of malaria in pregnancy is a highly cost-effective intervention which significantly improves maternal and birth outcomes among mothers and their newborns who live in areas of moderate to high malaria transmission. However, coverage in sub-Saharan Africa remains unacceptably low, calling for urgent action to increase uptake dramatically and maximize its public health impact. The ‘Global Call to Action’ outlines priority actions that will pave the way to success in achieving national and international coverage targets. Immediate action is needed from national health institutions in malaria-endemic countries, the donor community, the research community, members of the pharmaceutical industry and private sector, along with technical partners at the global and local levels, to protect pregnant women and their babies from the preventable, adverse effects of malaria in pregnancy © 2015 Chico et al. Open Access.
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  8. 8
    337733

    Controlling maternal anemia and malaria. Ensuring pregnant women receive effective interventions to prevent malaria and anemia: What program managers and policymakers should know.

    Maternal and Child Survival Program

    [Washington, D.C.], Maternal and Child Survival Program, 2015 Apr. [6] p. (USAID Cooperative Agreement No. AID-OAA-A-14-00028)

    This brief describes WHO recommendations for IPTp (intermittent preventive treatment of malaria in pregnancy) to prevent MIP (malaria in pregnancy) and iron-folic acid (IFA) supplementation to prevent iron deficiency anemia in sub-Saharan Africa (SSA) countries, with an emphasis on giving the correct dose of folic acid to maximize the effectiveness of interventions to prevent malaria. The brief is for program managers of health programs and policymakers to guide them in designing programs and developing policies. (Excerpts)
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  9. 9
    335060

    Larval source management: a supplementary measure for malaria vector control. An operational manual.

    World Health Organization [WHO]. Global Malaria Programme

    Geneva, Switzerland, WHO, 2013. [128] p.

    Larval source management (LSM) refers to the targeted management of mosquito breeding sites, with the objective to reduce the number of mosquito larvae and pupae. When appropriately used, LSM can contribute to reducing the numbers of both indoor and out-door biting mosquitoes, and -- in malaria elimination phase -- it can be a useful addition to programme tools to reduce the mosquito population in remaining malaria ‘hotspots’. This operational manual has been designed primarily for National Malaria Control Programmes as well as field personnel. It will also be of practical use to specialists working on public health vector control, and malaria programme specialists working with bilateral donors, funders and implementation partners. It has been written by senior public health experts of the malaria vector control community under the guidance of the WHO Global Malaria Programme. The manual’s three main chapters provide guidance on: the selection of larval control interventions, the planning and management of larval control programmes, and detailed guidance on conducting these programmes. The manual also contains a list of WHOPES-recommended formulations, standard operating procedures for larviciding, as well as a number of country case studies.
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  10. 10
    334884

    WHO policy brief for the implementation of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP).

    World Health Organization [WHO]. Global Malaria Programme; World Health Organization [WHO]. Department of Reproductive Health and Research; World Health Organization [WHO]. Department of Maternal, Newborn, Child and Adolescent Health

    [Geneva, Switzerland], WHO, 2013 Apr 11. [12] p.

    Malaria infection during pregnancy is a major public health problem, with substantial risks for the mother, her fetus and the newborn. In areas with moderate to high transmission of Plasmodium falciparum, the World Health Organization (WHO) recommends a package of interventions for controlling malaria and its effects during pregnancy, which includes the promotion and use of insecticide-treated nets (ITNs), the administration during pregnancy of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP), and appropriate case management through prompt and effective treatment of malaria in pregnant women . During the last few years, WHO has observed a slowing of efforts to scale-up IPTp-SP in a number of countries in Africa. Although there may be several reasons for this, an important factor is confusion among health workers about sulfadoxine-pyrimethamine administration for intermittent preventive treatment in pregnancy. At a recent WHO evidence review, a meta-analysis of 7 trials evaluating IPTp-SP was undertaken. It showed that 3 or more doses of IPTp-SP were associated with higher mean birth weight and fewer low birth weight (LBW) births than 2 doses of IPTp-SP. The estimated relative risk reduction for LBW was 20% (95% CI 6-31). This effect was consistent across a wide range of SP resistance levels. The 3+ dose group also was found to have less placental malaria. There were no differences in serious adverse events between the two groups . Based on this evidence review, in October 2012, WHO updated the recommendations on IPTp-SP as outlined in this document, and urges national health authorities to disseminate this update widely and ensure its correct application. IPTp-SP is an integral part of WHO’s three-pronged approach to the prevention and treatment of malaria in pregnancy, which also includes the use of insecticide-treated nets and prompt and effective case management. (Excerpts)
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  11. 11
    334736

    Updated WHO policy recommendation (October 2012): Intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP).

    World Health Organization [WHO]. Global Malaria Programme

    [Geneva, Switzerland], WHO, Global Malaria Programme, 2012 Oct. [2] p.

    Each year, 655,000 people die from malaria -- of these, 200,000 are newborns and 10,000 are mothers. Yet, recent evidence brings to light that use of bednets and intermittent preventive treatment by pregnant women, both powerful and cost-effective tools to prevent contracting malaria in areas of stable transmission, is associated with reductions in neonatal mortality and low-birth weight. The World Health Organization has updated its recommendations on the use of intermittent preventive treatment, urging countries to adapt their policies and practices to quickly scale-up this life-saving measure.
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  12. 12
    334706

    Indoor residual spraying: an operational manual for indoor residual spraying (IRS) for malaria transmission control and elimination.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2013. [116] p.

    This manual has been created to enhance existing knowledge and skills, and to assist malaria programme managers, entomologists and vector control and public health officers to design, implement and sustain high quality IRS programmes. Though comprehensive, this manual is not intended to replace field expertise in IRS. The manual is divided into three chapters: IRS policy, strategy and standards for national policy makers and programme managers; IRS management, including stewardship and safe use of insecticides, for both national programme managers and district IRS coordinators; IRS spray application guidelines, primarily for district IRS coordinators, supervisors and team leaders. This manual will enable national programmes to: develop or refine national policies and strategies on vector control; develop or update existing national guidelines; develop or update existing national training materials; review access and coverage of IRS programmes; review the quality and impact of IRS programmes.
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  13. 13
    334679

    Guidelines for laboratory and field-testing of long-lasting insecticidal nets.

    World Health Organization [WHO]. Department of Control of Neglected Tropical Diseases; World Health Organization [WHO]. Pesticide Evaluation Scheme

    Geneva, Switzerland, WHO, 2013. [99] p. (WHO/HTM/NTD/WHOPES/2013.3)

    Guidelines for testing long-lasting insecticidal nets (LNs) were first published by WHO in 2005. The revised guidelines were reviewed by a WHOPES informal consultation on innovative public health pesticide products, held at WHO headquarters on 22-26 October 2012. Industry was invited to attend the first 2 days of the meeting to exchange information and provide their views, after which their comments were further reviewed by a group of WHO-appointed experts, who finalized the guidelines by consensus. The purpose of this document is to provide specific, standardized procedures and guidelines for testing LNs for personal protection and malaria vector control. It is intended to harmonize testing procedures in order to generate data for registration and labelling of such products by national authorities and provide a framework for industry in developing novel LN products. This document replaces the previous guidelines, published by WHOPES in 2005. (Excerpts)
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  14. 14
    352945
    Peer Reviewed

    Development of vaccines to prevent malaria in pregnant women: WHO MALVAC meeting report.

    Menendez C; Moorthy VS; Reed Z; Bardaji A; Alonso P; Brown GV

    Expert Review of Vaccines. 2011 Sep; 10(9):1271-80.

    The major public health consequences of malaria in pregnancy have long been acknowledged. However, further information is still required for development and implementation of a malaria vaccine specifically directed to prevent malaria in pregnant women and improve maternal, fetal and infant outcomes. The WHO Malaria Vaccine Advisory Committee (MALVAC) provides guidance to the WHO on strategic priorities and research needs for development of vaccines to prevent malaria. Here we summarize the discussions and conclusions of a MALVAC scientific forum meeting on considerations in the development of vaccines to prevent malaria in pregnant women. This report includes brief summaries of what is known, and major knowledge gaps in disease burden estimation, pathogenesis and immunity, and the challenges with current preventive strategies for malaria in pregnancy. We conclude with the formulation of a conceptual framework for research and development for vaccines to prevent malaria in pregnant women.
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  15. 15
    349236
    Peer Reviewed

    Increased resources for the Global Fund, but pledges fall short of expected demand.

    Kazatchkine MD

    Lancet. 2010 Oct 30; 376(9751):1439-40.

    This commentary discusses how the pledges to the Global Fund to Fight AIDS, Tuberculosis and Malaria from countries, the private sector, and innovative funding sources have fallen short of the demand estimates, despite the pledged sum being the largest amount ever mobilized for global health. The US $11.7 billion pledge for the 2011-2013 time range is an increase of more than 20% over 2007-2010 and will go toward maintaining programs at their current scale and support further significant expansion of health services in many countries. It explains that the shortfall to meet the $13 billion will result in challenging decisions about which new programs to support and a slower rate of scale-up for new programs.
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  16. 16
    332634

    Progress for children. Achieving the MDGs with equity.

    UNICEF

    New York, New York, UNICEF, 2010 Sep. [92] p. (Progress for Children No. 9)

    ‘Achieving the MDGs with Equity’ is the focus of this ninth edition of Progress for Children, UNICEF’s report card series that monitors progress towards the MDGs. This data compendium presents a clear picture of disparities in children’s survival, development and protection among the world’s developing regions and within countries. While gaps remain in the data, this report provides compelling evidence to support a stronger focus on equity for children in the push to achieve the MDGs and beyond. (Excerpt)
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  17. 17
    332479

    Make or break? 2010: a pivotal year for scaling up RH / HIV integration and accelerating progress towards MDGs 5 and 6.

    Middleton-Lee S

    Washington, D.C., Global AIDS Alliance, 2010 Mar. [16] p.

    In the context of the five-year countdown to the Millennium Development Goals, missed targets on universal access to HIV / AIDS prevention, treatment, and care, and the Third Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the report details the unique demand-creation model used by the Mobilizing RH / HIV Integration Initiative during the Global Fund's Rounds 8 and 9. By identifying countries interested in submitting HIV / AIDS proposals to the Global Fund that integrated reproductive health services and health systems strengthening, working with RH and HIV / AIDS civil-society organizations as implementers and advocates, and supporting countries in producing high-quality, innovative, technically-sound proposals, the Mobilizing for RH / HIV Integration Initiative helped to demonstrate the breadth of RH- and MDG 5-related interventions eligible for support from the Global Fund as a strategy for most efficiently and effectively improving HIV / AIDS outcomes.This new report highlights the model used and the Initiative's successful outcomes at the global and national levels, and makes recommendations to donors, national governments, the Global Fund and its technical partners, and other stakeholders in successful Global Fund proposals and in meeting the internationally agreed-upon targets of MDGs 5 and 6.
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  18. 18
    332278

    The Global Fund 2010: Innovation and impact. Global Fund-supported programs saved an estimated 4.9 million lives by the end of 2009.

    Global Fund to Fight AIDS, Tuberculosis and Malaria

    Geneva, Switzerland, Global Fund to Fight AIDS, Tuberculosis and Malaria, 2010 Mar. [132] p.

    The substantial increase in resources dedicated to health through overseas development assistance and other sources during the past years has begun to change the trajectory of AIDS, tuberculosis (TB) and malaria, and more broadly, of the major health problems that low- and middle-income countries have been confronted with. The results and emerging signs of impact presented in this report paint a hopeful and encouraging picture. Ten years ago, virtually no one living with AIDS in low- and middle-income countries was receiving lifesaving antiretroviral therapy (ART), although it had been available since 1996 in high-income countries. At the end of 2008, over 4 million people had gained access to AIDS treatment, representing over 40 percent of those in need. AIDS mortality has since decreased in many high-burden countries. For example, in Ethiopia’s capital, Addis Ababa, the rollout of ART has led to a decline of about 50 percent in adult AIDS deaths over a period of five years.
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  19. 19
    332100

    Supporting community responses to malaria: A training manual to strengthen capacities of community based organizations in application processes of the Global Fund to Fight HIV / AIDS, Tuberculosis and Malaria.

    Odindo M; Mangelsdorf A

    Cologne, Germany, STOP MALARIA NOW!, 2009 Nov. 53 p.

    This training manual is a product of the STOP MALARIA NOW! advocacy campaign and aims to support community responses to malaria. In particular, this manual aims to improve knowledge and skills of Community Based Organizations (CBOs) in application processes of the Global Fund to Fight HIV / AIDS, Tuberculosis and Malaria. The contents are based on results of the needs assessment 'Capacity Needs of CBOs in Kenya in Terms of Application Processes of the Global Fund to Fight HIV /AIDS, Tuberculosis and Malaria (GFATM)', conducted in June and July 2009.
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  20. 20
    332082

    Report to Congress by the U.S. Global AIDS Coordinator on the involvement of faith-based organizations in activities of the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

    United States. Office of the United States Global AIDS Coordinator

    [Washington, D.C.], Office of the United States Global AIDS Coordinator, 2008 May. 40 p.

    The Administration provides this Report pursuant to Section 625(b) of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2008 (Division J, Public Law 110-161), which requires the U.S. Secretary of State to submit a report to the Committees on Appropriations "on the involvement of faith-based organizations in Global Fund Programs. The report shall include (1) on a country-by-country basis -(A) a description of the amount of grants and subgrants provided to faith-based organizations; and (B) a detailed description of the involvement of faith-based organizations in the Country Coordinating Mechanism (CCM) process of the Global Fund; and (2) a description of actions the Global Fund is taking to enhance the involvement of faith-based organizations in the CCM process, particularly in countries in which the involvement of faith-based organizations has been underrepresented.
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  21. 21
    332040

    The Millennium Development Goals report 2009.

    United Nations

    New York, New York, United Nations, Department of Economic and Social Affairs, 2009 Jul. 56 p.

    The Millennium Declaration set 2015 as the target date for achieving most of the Millennium Development Goals (MDGs), which established quantitative benchmarks to halve extreme poverty in all its forms. As the date approaches, less than six years away, the world finds itself mired in an economic crisis that is unprecedented in its severity and global dimensions. Progress towards the goals is now threatened by sluggish -- or even negative -- economic growth, diminished resources, fewer trade opportunities for the developing countries, and possible reductions in aid flows from donor nations. At the same time, the effects of climate change are becoming increasingly apparent, with a potentially devastating impact on countries rich and poor. Today, more than ever, the commitment to building the global partnership embodied in the Millennium Declaration must guide our collective actions. This report presents an annual assessment of progress towards the MDGs. Although data are not yet available to reveal the full impact of the recent economic downturn, they point to areas where progress towards the eight goals has slowed or reversed. (Excerpt)
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  22. 22
    332020

    Last chance for the world to live up to its promises? Why decisive action is needed now on child health and the MDGs. A World Vision policy briefing.

    World Vision

    Milton Keynes, United Kingdom, World Vision International Policy and Advocacy, 2008 Sep. 15 p. (World Vision Policy Briefing)

    Now is the window of opportunity to ensure that 2015 will be remembered as the year the world lived up to its promise to the world's poorest and most vulnerable people. This short briefing paper considers child health in the context of the three health-focused MDGs, identifies concrete steps needed in the coming months to put the MDGs back on track, and summarises World Vision's own efforts to contribute to their achievement. (Excerpt)
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  23. 23
    328671
    Peer Reviewed

    The challenges of diagnosis and treatment of malaria in pregnancy in low resource settings.

    Omo-Aghoja LO; Abe E; Feyi-Waboso P; Okonofua FE

    Acta Obstetricia et Gynecologica Scandinavica. 2008; 87(7):693-6.

    Malarial infestation in pregnancy is a major public health concern in endemic countries and ranks high amongst the commonest complications of pregnancy, especially in large areas of Africa and Asia. It is an important preventable cause of significant maternal morbidity and mortality with associated fetal as well as perinatal wastage. The burden of malaria is greatest in sub-Saharan Africa where it contributes directly or indirectly to maternal and perinatal morbidity and mortality. The need for prompt and accurate diagnosis as well as prevention and treatment of malaria during pregnancy cannot, therefore, be overemphasized. This commentary focuses on the challenges of diagnosis and treatment of malaria in pregnancy.
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  24. 24
    325623

    Plasmodium falciparum containment strategy.

    Agrawal VK

    MJAFI. Medical Journal Armed Froces India. 2008; 64(1):57-60.

    World Health Organization (WHO) estimates 1.7-2.5 million deaths and 300-500 million cases of malaria each year globally. As an initiative WHO has announced Roll Back Malaria (RBM) programme aimed at 50% reduction in deaths due to malaria by 2010. The RBM strategy recommends combination approach with prevention, care, creating sustainable demand for insecticide treated nets (ITNs) and efficacious antimalarials in order to achieve sustainable malaria control. Malaria control in India has travelled a long way from National Malaria Control Programme launched in 1953 to National Vector Borne Diseases Control Programme in 2003. In India, the malaria eradication concept was based on indoor residual spraying to interrupt transmission and mop up cases by vigilance. This programme was successful in reducing the malaria cases from 75 million in 1953 to 2 million but subsequently resulted in vector and parasite resistance as well as increase in P falciparum from 30-48%. In view of rapidly growing resistance of Plasmodium falciparum to conventional monotherapies and its spread in newer areas, the programme was modified with inclusion of RBM interventions and revision of treatment guidelines for malaria. Early case detection and prompt treatment, selective vector control, promotion of personal protective measures including ITNs and information, education, communication to achieve wider community participation will be the key interventions in the revised programme. (author's)
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  25. 25
    324673
    Peer Reviewed

    Sulphadoxine / pyrimethamine versus amodiaquine for treating uncomplicated childhood malaria in Gabon: A randomized trial to guide national policy.

    Nsimba B; Guiyedi V; Mabika-Mamfoumbi M; Mourou-Mbina JR; Ngoungou E

    Malaria Journal. 2008 Feb 12; 7:31.

    In Gabon, following the adoption of amodiaquine/artesunate combination (AQ/AS) as first-line treatment of malaria and of sulphadoxine/pyrimethamine (SP) for preventive intermittent treatment of pregnant women, a clinical trial of SP versus AQ was conducted in a sub-urban area. This is the first study carried out in Gabon following the WHO guidelines. A random comparison of the efficacy of AQ (10 mg/kg/day x 3d) and a single dose of SP (25 mg/kg of sulphadoxine/1.25 mg/kg of pyrimethamine) was performed in children under five years of age, with uncomplicated falciparum malaria, using the 28-day WHO therapeutic efficacy test. In addition, molecular genotyping was performed to distinguish recrudescence from reinfection and to determine the frequency of the dhps K540E mutation, as a molecular marker to predict SP-treatment failure. The day-28 PCR-adjusted treatment failures for SP and AQ were 11.6% (8/69; 95% IC: 5.5-22.1) and 28.2% (20/71; 95% CI: 17.7-38.7), respectively This indicated that SP was significantly superior to AQ (P= 0.019) in the treatment of uncomplicated childhood malaria and for preventing recurrent infections. Both treatments were safe and well-tolerated, with no serious adverse reactions recorded. The dhps K540E mutation was not found among the 76 parasite isolates tested. The level of AQ-resistance observed in the present study may compromise efficacy and duration of use of the AQ/AS combination, the new first-line malaria treatment. Gabonese policy-makers need to plan country-wide and close surveillance of AQ/AS efficacy to determine whether, and for how long, these new recommendations for the treatment of uncomplicated malaria remain valid. (author's)
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