New treatments for malaria in Colombia, 2006

Abstract

In Colombia, the official anti malaria treatments, falciparum and vivax, suddenly changed in October 2006. The objective of this work is to state the reasons why it is appropriate to maintain the above mentioned therapeutic schemes and to point out the problems that arise with the governmentÿs decision, as well as to suggest tasks for the immediate future.

As of October 2006 the anti malaria falciparum treatment will be as follows: in the Pacific Coast, (Chocó, Valle, Cauca, Nariño and the municipalities in Antioquia, Vigía del Fuerte and Murindó) the combination artemeter-lumefantrine will be given; in Antioquia and Córdoba the combination artesunate-mefloquine. Malaria vivax shall be treated with chloroquine-primaquine, administering primaquine 0,60 mg/kg/day in seven days instead of 0,25 mg/kg/day in 14 days.

The field assessments of the treatments in force until October 2006 showed the following efficacy levels: according to the WHO protocols, a) amodiaquine-sulphadoxine-pirimetamine for malaria falciparum 98%; cloroquine-primaquine 100% to cure acute attacks and 82% to prevent relapses. We do not know of any assessment carried out in Colombia with the schemes. The worldwide experience with the adopted schemes is rather scarce and the efficiency is not better than the one found here for amodiaquine-sulfadoxine-pirimetamine.

It is expected that the new treatments for malaria falciparum show efficacy levels of more than 90%, as well as the new malaria vivax scheme in cases of acute attacks but it is not expected to be the same or better for relapses. Several immediate tasks are suggested to the health authorities.