The Ministry of health has decided to replace chloroquine and fansidar combination with artemether and lumefantrine as the first line malaria treatment.
and H. Bainemigisha
The Ministry of health has decided to replace chloroquine and fansidar combination with artemether and lumefantrine as the first line malaria treatment. According to Dr John Bosco Rwakimari, the new arteminisin-based combination therapy has been approved by World Health Organisation (WHO).
But the drug has to be imported at a cost of sh20,000 per dose, forcing Uganda to rely on donor-money like the Global Fund to sustain access! There are other logistical issues like time taken in freight and limited shelf life, which the ministry has to grapple with.
Arteminisin was isolated from an annual plant known as Sweet Annie in china in 1972. The plant, also known as Sweet Wormwood, has scored 90% effectiveness in clinical trials, more successful than conventional drugs.
Arteminisin in Uganda
The good news is that this plant, known as Artemisia Annua, grows widely in some parts of the country. Prof John Kasenene of Botany department, Makerere university, says Batooro, call it Akeerurukara, while the Bakonzho call it Akayibwe. It often grows to more than two metres high and is usually single-stemmed with alternate branches. Its aromatic leaves are deeply dissected and the flowers are greenish-yellow, enclosed by numerous bracts.
Kasenene, who is also the director of Kibale National Park, says Artemisia Annua is being grown at a newly established botanical garden in Kabarole. Afro Alpine Pharma is also said to have established a 20,000-acre plantation of the anti-malarial plant in Kabale and Kisoro.
Rwakimari says the ministry of Agriculture is following all the developments to enable Uganda manufacture the required medicine.
Romano Fernandes of Kampala Pharmaceutical Industries (KPI) says manufacturing Arteminisin will solve the problem of outside dependence, delays in transportation and clearing at entry points.
â€œWe have the technical expertise and capacity, proven and endorsed by the National Drug Authority to manufacture drugs locally,â€ Fernandes told a workshop on implementing the combination therapy strategy at Hotel Africana recently.
Your own garden
According to Family Medicinal Plant Gardens by Monik Adriaens, Artemisia Annua is one of the basic medicinal plants you should plant in your home garden. You can buy hybrid seedlings, grow them in a nursery bed before transplanting them when they are about 15cm high, about 10 weeks after sowing.
Plant in a rainy season. As soon as the first flowers appear, cut the plant and strip the leaves from the stem and dry them.
You can also plant stem cuttings. â€œCut branches into short pieces of about 2cm long, remove all leaves and plant 1cm deep in the damp soil of a seedbed. When seedlings grow, transplant into garden,â€ Fernandes said.
According to Action for Natural Medicine ANAMED), after harvesting leaves, dry them and then pour boiling water over them. Leave it to cool for 15 minutes and then filter. The resulting tea is taken at six-hourly intervals.
According to Natural Medicine in the Tropics by Hans Hirt and Bindanda Mâ€™pia, adults can take one litre infused in 5g of dried leaves. Children take half a litre in 4g of dried leaves for those older than 13; 3g for those between 11 and 13 years of age and 2g for the seven-11 years. The dose is given for seven days.
If the fever keeps recurring, continue the treatment for 12 days. You can also take three fansidar tablets or any other conventional anti-malaria on the third day. To improve on its palatability, the tea can be sweetened with honey or sugar.
It should be noted that pregnant women must not take the tea, more so in the first three months of pregnancy. Young children should be given this tea strictly under the supervision and advice of a doctor. Malaria can cause death if untreated or when treated poorly.
ANAMED warns that artemisia tea should not be taken as preventive drug as there is too little experience of its use as a preventive drug.
Grow the anti-malarial plant