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Families Ensure Success of Antimalarial Study in Rwanda

Participating in a study to determine the effectiveness of an antimalarial medication—a therapeutic efficacy study—was well worth the time and effort it took, says Jean Bosco Nzirorera, adding that his family has been healthy and malaria-free ever since.

In 2018, Nzirorera, along with his wife Francine Uwimana and their son Ivan Ishimwe, who was just one year old and suffering from malaria, spent four days taking part in the study at Masaka Health Center. The couple agreed to participate, he says, because the study was of national importance.

The study results, published in August 2021 in The Lancet Infectious Diseases, show that in Rwanda, artemether-lumefantrine (AL) remains efficacious but reveal evidence of emerging artemisinin partial-resistance in Rwanda.

“There is no treatment failure that has been registered. As long as medication is working 96% and above, it is considered effective. We only get concerned if the effectiveness goes below 95%,” says Dr. Aimable Mbituyumuremyi, the head of Malaria and Other Parasitic Diseases Division (MOPDD) at Rwanda Biomedical Center (RBC), as quoted in The New Times.

Marie Therese Numuhire, laboratory technician, Masaka Health Center reads blood slides for detection of malaria parasites.

In Rwanda, the MOPDD, in collaboration with Jhpiego and the U.S. President’s Malaria Initiative, through the U.S. Agency for International Development and with technical guidance from the World Health Organization (WHO), is responsible for surveillance of antimalarial efficacy. Since 2000, the National Malaria Control Program has undertaken sentinel site-based surveillance of antimalarial efficacy using WHO-adapted protocols. This surveillance includes setting the antimalarial efficacy agenda/schedule, sourcing drugs and human resources, funding, choosing study sites, planning and implementing efficacy studies, and assuring that results feed into policy and program decisions.

As a complement to this surveillance, researchers conducted the therapeutic efficacy study to inform and guide malaria case management by testing the efficacy of first-line treatment, AL in Rwanda, according to Dr. Aline Uwimana, director of the Case Management Unit at MOPDD, and lead author of The Lancet article.

The participation of families, like Nzirorera’s, ensured that the AL therapeutic efficacy study in Rwanda was a success.

While at the Masaka Health Center, Ivan Ishimwe was successfully treated for malaria, a disease that affects as much as 7% of children under five (2017 Rwanda Malaria Indicator Survey). The couple also received counselling on how to better protect themselves and their son from malaria when they returned home to Kabeza Village.

“The advice we got during the time we spent at the hospital is beneficial to the whole family,” Nzirorera says. “Since then, none of us has got malaria because we use mosquito nets.”

Left to the right: Tharcisse Munyaneza (National Reference Laboratory Rwanda), Samaly S. Souza (U.S. Centers for Disease Control and Prevention) and Rafiki Madjid Habimana (National Reference Laboratory Rwanda), co-authors of the study, review malaria molecular laboratory results.

Jhpiego believes that when women are healthy, families and communities are strong. We won’t rest until all women and their families—no matter where they live—can access the health care they need to pursue happy and productive lives.

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