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Malaria Technical Director, National Malaria Elimination Programme, Professor Olugbenga Mokuolu says all the artemisinin-based combination therapies (ACTs) still in use in Nigeria is greater than 95 per cent efficacy. He therefore asked hospitals to continue to prescribe them to treat malaria.
He stated that hospitals should continue to prescribe them to treat confirmed malaria because there are no markers of resistance of malaria parasites to these antimalarial drugs yet in Nigeria.
Professor Mokuolu, in his lecture with the theme “Nigeria Malaria Management Landscape Inputs from the Ivory Tower,” to mark the 70th birthday and Valedictory programme in honour of Professor Catherine Falade, in Ibadan, said evidence in different areas of Nigeria indicates that ACTs work effectively in a confirmed malaria case.
According to him, for all the ACTs tested, in less than two days, more than 90 percent malaria parasite clearance is achieved and where there is a misdiagnosis of the fever, the malaria medicine would not work.
The expert said that the drug of choice for treating malaria was changed from Chloroquine to ACTs because chloroquine was no longer effective.
He added that 228 million cases of malaria and 7.6 million malaria-related deaths were averted between 2000 and 2019 by different malaria interventions instituted across the country.
Mokuolu declared “multiple parameters show that Nigeria is making progress in malaria elimination. The number of deaths related to malaria is coming down; a significant amount of malaria cases has been prevented. The prevalence of malaria in Nigeria in 2014, 2015, 2018 and 2021 was 42%, 27%, 23% and 22% respectively.
“The antimalarial drug resistance is yet to come to Nigeria, we don’t have the resistant mutation in Nigeria yet. We are preparing, we are trying to look for alternate molecules that can be used because if it comes in, it can be devastating. But to prevent that, we appeal to stop the indiscriminate use of ACTs.
“Most of the claim that ACTs was failing is because the condition may not have been malaria in the first instance. When we test people, you may not find more than 3 to 4 out of 10 with proven malaria and yet for every fever, you are likely to treat 9 out of 10 persons for malaria if tests were not done.
“The way ACTs work is slightly different from that of Chloroquine. Chloroquine brings down fever and you start having some relief in the first few hours, although it does not mean that it is curing malaria. But ACTs cure malaria and you see their final effect towards the end of the second and third day. That confusion between how chloroquine works and the current drug is one of the reasons why people are quick to say the ACTs is not working.”
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