Coartem: The new malaria drug

Oct 11, 2005

A NEW strong anti-malarial drug called coartem has hit the market. Coartem, a combination of Artemether (an artemisinin derivative) and lumefantrine has undergone a three-year laboratory test at Mbarara University of Science and Technology by world professionals in public health and epidemiology.

By K. Muhanga
and T. Makokha


A NEW strong anti-malarial drug called coartem has hit the market. Coartem, a combination of Artemether (an artemisinin derivative) and lumefantrine has undergone a three-year laboratory test at Mbarara University of Science and Technology by world professionals in public health and epidemiology.

Dr. Patrice Piola, an epidemiologist and the country representative for Epicenter, an organisation that supervised the research, says the drug has been proved effective in the treatment and management of malaria after going through a series of trials at the science-based university.

“So far, coartem is proving to be a fast-acting anti-malarial drug. It kills malaria parasites within 48 hours and has a reported cure rate of 95%,” Piola says. “A number of trials have demonstrated that coartem is safe and well tolerated. Unlike Fansidar, coartem contains no sulphur, which many people are allergic to.”

Dr. Isaac Kigozi of National Drug Authority says, under normal circumstances, a patient on coartem treatment recovers in three days. “Some people show signs of recovery on the first day they are put on coartem,” he says.

Piola says the combination of artemether and lumefantrine in coartem rapidly clears malaria parasites, treats most symptoms of malaria and prevents recrudescence. He says the drug has been successfully used in different areas where multi-drug resistance has been growing like Kenya, Burundi, Zanzibar, Zambia and Zimbabwe.

Prof. Nozmo Mukiibi, the acting dean of medical school at the university says proper and consistent use of the drug would combat malaria, which was increasingly getting more resistant to traditional drugs like Chloroquine and Fansidar. “The results with coartem are already visible. All cases during the tests are reporting positive results,” Mukiibi says.

Dr C. Sezi, an expert on malaria treatment at Mulago Hospital, says the use of coartem in the management of malaria was adopted way back in 2004 after a series of consultative meetings. “The growing ineffectiveness of the Chloroquine and Fansidar over the last two years necessitated that we introduce artemisinin-based combination therapy in the treatment of malaria,” Sezi says.

Piola says coartem is taken orally with fluids, preferably drinks containing fat, such as milk. A full treatment is a three-day course and the number of tablets per dose depends on body weight.

He says a dose for an adult of above 45kg consists of 24 tablets taken at rate of four tablets twice a day for three days.

Kigozi says like all other medicines, coartem too has some side effects. “The use of coartem might come with slight stomach upsets. Fortunately, they are not a common occurrence.” He says the biggest limitation of coartem like all artesunate-based drugs remains the prohibitive cost.

A single dose of coartem in pharmacies in Mbarara town costs between sh15, 000 and sh30, 000. This, according to John Rwakimari, the Malaria Control Programme manager in the Ministry of Health, is because the formulation of the drug as patent, is owned by one company.

“The supply line is very limited, thus putting the price beyond what an average person can afford,” Rwakimari says. He says unlike chloroquine and fansidar, artesinin-based combination therapies are more costly.

He also says coartem as an artesunate-based drug has a limited shelf life of 24 months. This naturally puts a limit on the quantity procured at a time and demands that all stock is used within a specific period.

Kigozi says the Ministry of Health is working on a programme where coartem will be highly subsidised and later made available in health centres for at no charge. He says with coartem becoming the official malaria treatment drug, the government will be procuring it in large quantities, which will substantially bring the prices down.

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