By Raymond Baguma

THE World Health Organisation (WHO) has released new guidelines for the treatment of malaria. It recommends that oral artemisinin-based monotherapy should be removed from the market because its use promotes parasite resistance.

The new guidelines emphasise testing before treating.

“Treatment based on clinical symptoms alone should be reserved for settings where diagnostic tests are not available,” the agency said in a statement on yesterday.

It said countries must ensure that patients take the full dose of ACTs to prevent the development of drug resistance.

Dr. Kenya Mugisha, the director of clinical services, said Uganda no longer uses monotherapy treatment since chloroquine and fansidar were replaced with artemisinin combinations as the first-line treatment.

He, however, acknowledged that the country has limited microscope facilities; also the use of rapid diagnostic testing kits is still new in the country.

In 2008, just 22% of suspected malaria cases were tested in 18 of 35 African countries reporting. The world health body has also recommended a fifth artemisinin-based combination called dihydroartemisinin and piperaquine.

Every year, almost 250 million people are infected with malaria, causing 860,000 deaths. About 85% of these are among children, mainly in Africa.

In the guidelines, WHO also said poor quality medicines affect the health and lives of patients, damage the credibility of health services and help develop drug resistance.

The guidelines follow a recent study by a US-based group which established that 26 percent of anti-malarial drugs in Uganda are substandard.

WHO, therefore, warned that even artemisinin-based combination therapies could become ineffective if not well managed.