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Unapproved Drugs May Cause Resistance

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MBOMBELA – So-called health products, reputedly containing artemisinins and marketed as able to prevent malaria, can do more harm than good.

Dr Louis Hartley, who practices in Mbombela, said artemisinin-based combination therapies (ACTs) are the first line of treatment of the potentially fatal disease, but that products containing small amounts of ineffective artemisinins rather promote resistance to effective treatment than offer protection.

He expressed major concerns about supposedly “natural compounds” being promoted as antimalarial because they are reputed to contain artemisinins.

“These compounds are not effective in preventing malaria,” he said. What is more worrying is that the use of these products exposes the parasites to subtherapeutic levels of the drug that promote them developing resistance to effective treatment. Only a very limited number of artemisinins have antimalarial properties, Hartley explained.

“Even the effective artemisinins are not recommended for the prevention of malaria, because their short half-life renders them completely unsuitable and ineffective for prevention.”

Hartley pointed out that antimalarial drug resistance was the greatest threat to the control and eventual elimination of malaria.

He pointed out that recognising the symptoms was crucial to treat malaria.

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Robyn Baard, manager of patient experience at Mediclinic Nelspruit, said they had 19 positive malaria cases in April. Of them, six reported that they had spent time in Mozambique or live there.

“There were three cases from the Kruger National Park (KNP) area. Other areas that are reported are Marloth Park, Graskop, Phalaborwa, Hoedspruit and Malalane,” Baard said.

In May a total of 29 cases were reported. Eight were from the KNP, five are from Lydenburg, and four from Mozambique. Marloth Park had two, Hoedspruit two, Burgersfort, Ohrigstad, Bushbuckridge and KwaZulu-Natal had one each.

Hartley noted that the malaria risk for travellers, particularly those going to Mozambique, remained high and prevention was key.

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