From chloroquine to artemisinin-based combination therapy: the Sudanese experienceReport as inadecuate




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Malaria Journal

, 5:65

First Online: 31 July 2006Received: 05 March 2006Accepted: 31 July 2006

Abstract

BackgroundIn Sudan, chloroquine CQ remains the most frequently used drug for falciparum malaria for more than 40 years. The change to artemisinin-based combination therapy ACT was initiated in 2004 using the co-blister of artesunate + sulfadoxine-pyrimethamine AS+SP and artemether + lumefantrine ART+LUM, as first- and second-line, respectively. This article describes the evidence-base, the process for policy change and it reflects the experience of one year implementation. Relevant published and unpublished documents were reviewed. Data and information obtained were compiled into a structured format.

Case descriptionSudan has used evidence to update its malaria treatment to ACTs. The country moved without interim period and proceeded with country-wide implementation instead of a phased introduction of the new policy. The involvement of care providers and key stakeholders in a form of a technical advisory committee is considered the key issue in the process. Development and distribution of guidelines, training of care providers, communication to the public and provision of drugs were given great consideration. To ensure presence of high quality drugs, a system for post-marketing drugs surveillance was established. Currently, ACTs are chargeable and chiefly available in urban areas. With the input from the Global Fund to fight AIDs, Tuberculosis and Malaria, AS+SP is now available free of charge in 10 states.

ConclusionImplementation of the new policy is affected by the limited availability of the drugs, their high cost and limited pre-qualified manufacturers. Substantial funding needs to be mobilized by all partners to increase patients- access for this life-saving intervention.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2875-5-65 contains supplementary material, which is available to authorized users.

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Author: EM Malik - TA Mohamed - KA Elmardi - RM Mowien - AH Elhassan - SB Elamin - AA Mannan - ES Ahmed

Source: https://link.springer.com/



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