What next after Fansidar? The question of antimalarial drugs in Ethiopia

Abstract

In Ethiopian settings, patients getting the required treatments for malaria complications in hospitals would constitute a negligible percentage; malaria in Ethiopia hence, possibly costing millions of lives a year based on a 4.1% hospitalization rate (1). The fatal effects of falciparum malaria, however, depends on the local eco-epidemiology and malaria endemicity with its immune profile, population density and age structure, health infrastructure and level and rate of drug resistant Plasmodium falciparum. At present chloroquine cure rate in Ethiopia is expected in the range of 30-70% (2,3), in some areas even going below 15% (4). This has triggered a shift to sulfadoxine-pyrimethamine S-P, trade marked Fansidar, as a 1st line drug in line with chloroquine (cq). S-P is presently considered highly (>95%) efficacious (3,5) in Ethiopia.