WANMAT II: West Africa Network for Monitoring Antimalarial Treatment.

Situation:

Drug resistance of the malaria parasite to previously commonly used drugs, chloroquine and sulphadoxine-pryimethamine is widespread and as a result new combinations of antimalarials are now used to treat uncomplicated malaria. Drug combinations delay further transmission of resistant parasites by increasing cure rates and inhibiting formation of gametocytes.

Currently WHO and RBM recommended drug combinations are variants of artemisinin combination therapy (ACT). Fast acting, highly effective, artemisinin-based compounds are combined with a drug of longer half-life from a different class, such as lumefantrine or amodiaquine.

Response:

Decisions to change the antimalarial treatment in a country depend greatly on good monitoring of the efficacy of current medicines. The Malaria Consortium, through funding from Gates Malaria Partnership, provides technical advice and is a very active member of the West African Network for Monitoring Antimalarial Treatment (II) covering Benin, Burkina Faso, Côte d'Ivoire, Ghana, Mali, Niger, Nigeria, Sierra Leone and Togo. This is one of six regional networks in Africa monitoring anti-malarial drug efficacy. Support to the nine countries included the development of field manuals for antimalarial drug efficacy monitoring. Other support covers the implementation of ACT and improved quality of malaria diagnosis and data collection in sentinel sites.

Points to note:

The importance of ongoing support for networks to monitor the efficacy of anti-malarial treatment is crucial. Any failures of the drug policies need to be detected as quickly as possible so that prompt action can be taken. In addition, the sentinel sites of the networks are ideal for other related activities such as phamacovigilance or monitoring of transmission levels.