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Therapy of falciparum malaria in Sub-Saharan Africa: from molecule to policy

Winstanley, P., Ward, Stephen ORCID: https://orcid.org/0000-0003-2331-3192, Snow, R. and Breckenridge, A. (2004) 'Therapy of falciparum malaria in Sub-Saharan Africa: from molecule to policy'. Clinical Microbiology Reviews, Vol 17, Issue 3, 612-+.

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Abstract

The burden of falciparum malaria remains as great as ever, and, as has probably always been the case, it is carried mainly by tropical Africa. Of the various means available for the control of malaria, the use of effective drugs remains the most important and is likely to remain so for a considerable time to come. Unfortunately, the extensive development of resistance by the parasite threatens the utility of most of the affordable classes of drug: the development of novel antimalarials has never been more urgently needed. Any attempt to understand the vast complexities of falciparum malaria in Africa requires an ability to think "from molecule to policy." In consequence, the review ambitiously tries to examine the current pharmacopeia, the process by which new drugs are developed and the ways in which drugs are actually used, in both the formal and informal health sectors. The informal sector is particularly important in Africa, where around half of all antimalarial treatments are bought from informal outlets and taken at home without supervision by health care professionals: the potential impact of adherence on clinical outcome is discussed. Given that the full costs are carried by the patient in a large proportion of cases, the importance of drug affordability is explored. The review also discusses the splicing of new drugs into national policy. The various parameters that feed into deliberations on changes in drug policy are discussed.

Item Type: Article
Uncontrolled Keywords: placebo-controlled trial cost-effectiveness analysis childhood cerebral malaria antimalarial drug policy plasmodium-falciparum pyrimethamine-sulfadoxine chloroquine resistance home treatment rural area combination therapy
Subjects: W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 85 Patients. Attitude and compliance
QV Pharmacology > Anti-Inflammatory Agents. Anti-Infective Agents. Antineoplastic Agents > QV 256 Antimalarials
QX Parasitology > Protozoa > QX 135 Plasmodia
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department: Groups (2002 - 2012) > Molecular & Biochemical Parasitology Group
Digital Object Identifer (DOI): https://doi.org/10.1128/CMR.17.3.612-637.2004
Depositing User: Sarah Lewis-Newton
Date Deposited: 15 Mar 2012 18:24
Last Modified: 06 Feb 2018 13:03
URI: http://archive.lstmed.ac.uk/id/eprint/2142

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