Combination therapy to treat malaria is the simultaneous use of two or more drugs that kill the plasmodium parasite in different ways. NIMR researcher Julius Massaga is investigating the combination of Artesunate, one of the artemisinin family of highly effective anti-malarial drugs, and artemether-lumefantrine, Tanzania’s drug of choice for treatment of uncomplicated malaria.

The study is focusing on children under five. They are typically the most severe cases of malaria because they have developed no immunity through previous exposure. They need to be treated within 24 hours of the first symptoms to minimize the chances of simple malaria progressing to the severe complicated form of the disease which can be fatal.

Dr. Massage is evaluating two different approaches to community-based treatment of infected children with Artesunate combination drug therapy:
•    Mother coordinators (MCs) – the village is divided into segments and each segment has a “mother” trained to oversee malarial fever management in small children.
•    Community owned resource persons (CORPs) – One person in each village is trained to support malaria case management and act as a service delivery point.

At the first sign that a child has contracted malaria, he is taken to the MC or CORP, who administers the first dose of combination drugs. The remainder of the three-day, six-dose regimen is administered at home.

If  Dr. Massaga’s study determines that this Home Management of Malaria (HMM) strategy is feasible, socially acceptable, safe and effective, it could lead health policy planners to focus on scaling up HMM programs throughout Tanzania.  

Expected outcomes:
•    Assessing feasibility, acceptability and safety of pre-packaged ACT on malarial fevers through community based distribution in Tanzanian childern below five years of age

Impact:
•    Reduction of malaria associated mortality in <5s accessing treatment within 24hrs of smptoms onset
•    Establish the role of Rapid Diagnostic Tests  in the context of Home Management of Malaria strategy with ACTs in Tanzania
•    Improve rational use of antimalarial drug