MALARIA SITUATION AND THE USE OF HERBAL ANTIMALARIA DRUGS IN THE DEMOCRATIC REPUBLIC OF CONGO MESIA KAHUNU GAUTHIER 1 UNIVERSITY OF KINSHASA, FACULTY OF PHARMACY, KINSHASA XI DEMOCRATIC REPUBLIC OF CONGO 2 UNIVERSITY OF ANTWERP (UA), UNIVERSITEITSPLEIN 1, B-2610-ANTWERP, BELGIUM AFRICA HERBAL ANTIMALARIA MEETING ORGANISED BY THE WORLD AGROFORESTRY CENTRE (ICRAF) AND THE ASSOCIATION FOR THE PROMOTION OF TRADITIONAL MEDICINE (PROMETRA
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MALARIA SITUATION AND THE USE OF HERBAL ANTIMALARIA DRUGS IN THE DEMOCRATIC REPUBLIC OF CONGO MESIA KAHUNU GAUTHIER 1 UNIVERSITY OF KINSHASA, FACULTY OF.
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MALARIA SITUATION AND THE USE OF HERBAL
ANTIMALARIA DRUGS IN THE DEMOCRATIC REPUBLIC OF CONGO
MESIA KAHUNU GAUTHIER
1UNIVERSITY OF KINSHASA, FACULTY OF PHARMACY, KINSHASA XI DEMOCRATIC REPUBLIC OF CONGO
2UNIVERSITY OF ANTWERP (UA), UNIVERSITEITSPLEIN 1, B-2610-ANTWERP, BELGIUM
AFRICA HERBAL ANTIMALARIA MEETING ORGANISED BY THE WORLD AGROFORESTRY CENTRE (ICRAF) AND THE ASSOCIATION FOR THE PROMOTION OF TRADITIONAL MEDICINE (PROMETRA
DRCongo is located in the centre of Africa.POPULATION: 52,770,000 inhabitantsSURFACE : 2,345,000 Km2 Crossed by the equator, two seasons ( dry and rainy ), abundant flora ( four vegetation zones ).TROPICAL SUBSAHARAN COUNTRY ( 90 % MALARIA, the most affected region )
MALARIA AND PUBLIC HEALTH IN DRCONGOMalaria is:
-The major public health problem
-The first cause of morbidity and mortality ( particulary: children < 5 years old
and pregnant women )
Main indicators: - Endemicity: 100% -Transmission: - Stable: 97% - Seasonal: 2% ( East mountainous region ) -Malaria cases have been estimated at: -4,4 mio ( MSP, 2004 ) -59 to 80% Children -Death: - 17,200 - 1/5 ( 80 % of sick persons don’t frequent hospitals, not notified )
Principal vector: Anopheles gambiae
Majority of infections ( 95 %) : Plasmodium falciparum
NATIONAL POLICY FOR THE STRUGGLE AGAINST MALARIA
The government has set up a national policy to face this serious situation,
based on:
I. Prevention measures: -Improvement ( in and around homes)
-Insecticide spraying
-Impregnated mosquito nets with insecticide
( deltamethrine )
II. Treatments: -Presumptive ( symptoms, fever )
-Precocious ( early ) ( prevent complicated malaria)
-Correct ( recommended drugs, correct dosage )
III. Epidemiological surveillance
ANTIMALARIAL DRUGS POLICY (1)May 2000 to nov 2001 : first chemosensitivity studies ( 8 sites ) WHO protocol 1996 (clinical responses only ): CQ, SP Nov 2001: CQ : uncomplicated SP : failure or allergy QFailure rate: CQ: 29.4 to 80 % SP: 0 to 19.2 %Change of drugs policy ( intermediary period of two years ): SP / Q
Mikalayi
MikalayiCQ 29,4 % ; SP 0 %
KimpeseCQ 50 % ; SP 10 %
KinshasaCQ 35.2 % ; SP 5.5 %
VangaCQ 48.8 %; SP 4.8 %
KisanganiCQ 48 % ; SP 19.2 %
BukavuCQ 80 % ; SP 9. 3 %
KapoloweCQ 34 %; SP 3.9 %
Therapeutic failure rate
June 2002- june 2004 : second studies of therapeutic efficiency WHO protocol 2001 (clinical responses + residual parasitaemia) Combinations ( SP + AQ, SP + ART, AQ + ART )
Presently ( 2005 ) : ART + AQ / Q SP ( intermittent preventive treatment )