Malaria N° 9 - Subject N° 12

DEVELOPMENT OF AN ANTIMALARIAL DRUG POLICY
J.J.W. Wirima

SUMMARY
INTRODUCTION

Prior to 1984 treatment of uncomplicated malaria in Malawi was with a single dose of chloroquine at 10mg/kg. By 1983, clinical and parasitological failures began to be noticed across the country.

RESPONSE

The Na tional Malaria Control Committee was formed in 1984. Drug efficacy studies were undertaken with chloroquine at various doses, halofantrine, quinine, SP and mefloquine.
Initial national policy recommended chloroquine at the higher dose of 25mg/kg divided over three days for an uncomplicated malaria and quinine for severe malaria.
Continued monitoring of these drugs revealed increasing level of resistance to chloroquine even at the higher dose while the response to SP remained favourable.
Malawi, therefore, became the first country in 1993 to switch from chloroquine to SP as a first line drug for the treatment of non-severe malaria. Quinine remained the drug of choice for complicated malaria.
Data will be presented to support the above statements.