Kabarole hospital ignoring new WHO malaria treatment guidelines

Health facilities in Kabarole district are yet to adhere to the guidelines for treating severe malaria issued by the World Health Organization- WHO.

In 2013, the WHO recommended that artesunate, a derivative of artemisinin that is injected directly into the vein, replace quinine as the preferred treatment for severe malaria.

However a survey by Uganda Radio Network around Kabarole district found that major facilities like Rwimi, Karambi and Busoro Health Centre III still administer quinine to patients with severe malaria.

At Karambi Health Centre III, Fred Kugonza, a health worker says that they are still using the standard treatment for severe malaria which is an intravenous infusion of quinine or quinidine. Kugonza however says that patients  are often referred to Fort Portal Regional Referral Hospital when they become resistant to quinine treatment.

Enock Balya, the in-charge of the malaria ward at Rwimi Health Centre III says that he is aware of the new drug, but none of the health workers at the facility knows how to administer it.

Moses Businge, the Kabarole district malaria focal person, says that failure to use artesunate could cause an increase in cases of severe malaria leading to deaths especially in children. He adds that in facilities such as Fort Portal Regional Referral Hospital, there is no constant supply of artesunate injection.

Dr Richard Mugahi, the Deputy District Health Officer says that officials from the Malaria Consortium are yet to train medical workers about use of the drug. Several drugs have been used to treat malaria, which remains the number one cause of morbidity and mortality in Uganda.

In 2000, chloroquine was the first-line drug for treatment of uncomplicated malaria in Uganda.  However, between 2001 and 2004, the efficiency of chloroquine reduced significantly, with treatment failure ranging from 22 percent to 77 percent.

In 2004, in line with the WHO recommended threshold for antimalarial drug policy change, Uganda embarked on yet another policy change process that culminated in the adoption of artimesinin combination therapies as the first-line treatment for uncomplicated malaria.

According to WHO 1.2 million people die of malaria every year, 86 percent of whom are children under the age of 5. It also states that severe malaria represents end stage of untreated or improperly treated uncomplicated malaria.