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Home Treatment of Malaria May Lead to Overuse of Drugs

At-home management may not be best in low-prevalence areas

TUESDAY, April 14 (HealthDay News) -- Although malaria cases managed at home are treated promptly, they are also prone to overuse of malaria drugs, according to the results of a study published online April 14 in The Lancet.

Sarah G. Staedke, M.D., of the London School of Hygiene and Tropical Medicine in London, U.K., and colleagues conducted a study of 437 Ugandan children aged from 1 to 6 years, of whom 225 were randomized to presumptive treatment of febrile illness using prepackaged artemether-lumefantrine at home, while 212 received current standard of care.

The clinical outcomes of both groups were almost the same, except for the number of patients with parasitemia at the 12-month mark, with 17 (10 percent) of the control group affected versus four (2 percent) of the treatment group, the investigators found. However, patients in the treatment group received 4.66 antimalarial treatments per person-year versus 2.53 for the control group, the report indicates.

"Artemether-lumefantrine provided in the home might not be appropriate for large urban areas or areas with fairly low malaria transmission," the authors write. "However, our findings do not conflict with the existing evidence for home management of malaria in rural areas where transmission is high and distances to health facilities are often great. Nevertheless, home management in lower-transmission areas should not be assumed to be effective, especially since the costs of artemisinin-based combination therapies are high."

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