A team of organisations is embarking on a study to evaluate emergency response tools for severe malaria cases in rural Sub-Saharan Africa, particularly Zambia, Tanzania and the Democratic Republic of Congo.
"The new SEMA ReACT (SEvere MAlaria treatment with Rectal artesunate and Artemisinin-based Combination Therapy [in remote settings]) consortium aims to fill the evidence gap in the use of an intervention to buy time to seek further care in remote contexts where health facility transfer is not feasible," said Swiss-based Medicines for Malaria Venture (MMV), which added that the study would be “observational.”
MMV said access to hospitals in some areas required six hours or more of road travel which rendered them "entirely out of reach for people who contract severe malaria in highly isolated settings," resulting in poor recovery rates.
"Artesunate rectal capsules will be administered at the community level and clinical outcomes and potential signs of drug resistance will be evaluated. Then the intervention will be followed-up with the administration of oral artemisinin-based combination therapies once patients are well enough to swallow medicine," MMV explained.
According to MMV, despite concerns raised by the World Health Organisation "there is little guidance to inform frontline health workers on what to do when confronted with no timely options to transfer severely ill patients to higher level health centres.”
Zambia's Tropical Diseases Research Centre (TDRC) will take the scientific lead in the study, the University of Kinshasa in DR Congo handle the social science component while Tanzania's National Institute of Medical Research will be in charge of related molecular analysis.
Christine Manyando, head of public health at TDRC, said the researchers would investigate how home-grown solutions could be "implemented in communities most affected by malaria and the lsustainability of such lifesaving strategies.”
But according to Jean-Pierre Van Geertruyden of the University of Antwerp, new tools to combat malaria could only be useful if integrated in national healthcare policies and practices.
In its December 2022 report, WHO said global malaria deaths rose to 625,000 in 2020 - the first year of the Covid pandemic - from 568,000 in 2019 before the pandemic struck.
The deaths dropped slightly to about 619,000 in 2021 but infections rose from 232 million in 2019, 245 million in 2020, and 247 million in 2021.
About 95 percent of malaria cases and 96 percent of deaths worldwide in 2021 occurred in Africa with children under the age of five accounting for nearly 80 percent of the death on the continent.
"Four African countries – Nigeria (26.6 percent), DR Congo (12.3 percent), Uganda (5.1 percent) and Mozambique (4.1 percent) – accounted for nearly half of all malaria cases globally in 2021," the WHO report said.
It added that eradication efforts still face challenges "despite successes that have included artemisinin-based combination therapies."
The research is being funded by a European consortium, whose include the European and Developing Countries Clinical Trials Partnership, the Swiss State Secretariat for Education, Research and Innovation, the Global Health Institute at the University of Antwerp in Belgium and the Medicines for Malaria Venture.