Treating uncomplicated malaria in children: comparing artemisinin-based combination therapies.
OBJECTIVE
In response to increased resistance to conventional drugs, the WHO is promoting artemisinin-based combination therapy (ACT) for treating uncomplicated malaria. The objective of this report is to review the available evidence on the efficacy and effectiveness, acceptability, and deployment of ACT in resource-limited settings with a focus on sub-Saharan Africa.


RESULTS
ACTs are very effective in the treatment of uncomplicated Plasmodium falciparum malaria in children. ACTs are relatively safe and tolerable with no reported resistance in sub-Saharan Africa despite indications of delayed clearance of infections in south-east Asia. The major challenges to the widespread use of ACT include its high cost, availability, and inefficient delivery due to, among other things, weak healthcare systems.


CONCLUSIONS
ACTs are an essential tool in the fight to control and eliminate malaria. They are currently the most effective drugs against P. falciparum malaria. They should be deployed through programs that address availability, cost, adherence, and quality assurance. Initiatives including home-based management of malaria, improving public sector procurement and supply chains, and reducing private sector pricing should make ACTs more accessible for sub-Saharan African children who bear the brunt of the burden of malarial disease.
Yeka
Adoke
A
Uganda Malaria Surveillance Project, Kampala, Uganda. yadoke@muucsf.org
Harris
Jamal C
JC
D017954:Africa South of the Sahara; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D001210:Asia, Southeastern; D002648:Child; D004338:Drug Combinations; D006297:Health Services Accessibility; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D010342:Patient Acceptance of Health Care
D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; C031327:artemisinin