Researchers say that taking malaria medication inappropriately results into resistance to drugs.  

Malaria is caused by parasitic protozoans which affect humans.

The deadly disease causes symptoms that include fever, dizziness, vomiting, and headache. In severe cases it can cause yellow skin, seizures and death.

The disease is mostly found in the tropical zone because of the favourable breeding conditions.

In Rwanda, the highest prevalence of malaria is in Ngoma, Bugesera, Kayonza and Rwamagana districts in Eastern Province, and in the Southern Province districts of Huye, Nyanza, Kamonyi and Ruhango, according to the Ministry of Health.

Dr Aimable Mbituyumuremyi, the Director of Malaria Prevention Division at Rwanda Biomedical Centre, said some of the pesticides used to kill mosquitoes are no longer effective because the mosquitoes have become resistant to them.

He associates it with the rising malaria prevalence since 2012.

The plasmodium also develops resistance to a certain drug if they are not taken as instructed by medical personnel, he said.

‘‘Not following medical prescriptions while taking drugs makes them lose immunity towards the microbes, and therefore, cannot be effective,” he said.

Dr Mbituyumuremyi adds that it’s possible that one becomes resistant to the drugs due to continued inappropriate administration. 

Aline Uwimana, the director of Medicine in the Division of Malaria Prevention at RBC, said every two years, they conduct a study to see if the used medications against malaria still have their full potential to effectively kill plasmodium.

Uwimana said even before introducing malaria medication in the country, it is tested to see if they are worth consumption.

Level of effectiveness  

"There are different steps through which a certain type of medicine is tried before it is approved for use. It is tested in four phases, first in the laboratory to see if it’s effective, and then on some animals to see its potential,” she said. 

It is also checked for some side effects like harming the liver and other organs, and then it is applied to a small group of patients with malaria to see if their bodies react positively to the drug, she explained. 

Researchers then check if the drug is able to kill all microbes in the blood before being used freely on patients, she said.

Uwimana said some medicines get replaced if research shows it has lost its potential to cure. 

"Many adults have used a medicine called Chroloquine which in 2000 was replaced because it had lost capacity to cure after our study showed that only one patient among four could be cured by it. We have standards set by World Health Organization that we follow to measure if a certain medicine has to be replaced or not. When a drug cures at 95 per cent, it’s accepted to be used.

However, when it falls to 90 per cent, it’s time to think of ways to replace it,’’ she said.

Chroloquine was replaced by Amodiaquine Facidal, which was also replaced in 2006 with artemether/lumefantrine, also known as Coartem, which is still being used today.

Safe drugs

When people abuse the prescriptions given to them, the microbes become resistant and can be passed from an individual to an entire community and beyond.

For example, if someone suffering from malaria doesn’t take the prescribed drugs efficiently, the microbes in their blood reduce and when the vector bites another person, they get resistant malaria, which can’t be cured by the same drug, he said.

"If a patient is given drugs for three days, which they are supposed to take four times a day, and they instead take it twice a day and give the other two tablets to their colleague who doesn’t want to go to the hospital, both of them will not be cured and the microbe will develop resistance to the drug,” he said.

Uwimana said that if people suffer from malaria or from other diseases, they have to take medications prescribed by the approved health professionals, instead of buying them on their own.

"Malaria’s current medication, for instance, is still safe to use because its effectiveness is at 98 per cent. The drugs we provide to people are trusted and safe. We conduct trials every two years and the quality units available at Rwanda Drug, Consumables and Equipment Central Procurement Agency (CAMERWA) are only safe for use,” she added. 

In terms of safety in medical stores, she said they make sure the medications are stored in a proper place to avoid damages and to preserve their quality.

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