Saving Lives of Children with Severe Malaria in DRC: Can Artesunate Suppositories Buy Time to Get to Treatment?

 {Photo credit: MSH}Baby Ilunga with his mother, Ruth Mukadi.Photo credit: MSH

Young children at 10 community care sites already benefiting from new study

In 2012, malaria was the leading cause of death for children under the age of five in Democratic Republic of the Congo (DRC), accounting for 18 percent of under-five deaths.

DRC’s National Malaria Program (PNLP) is implementing a minimum package of interventions interventions against malaria nationwide, supported in 68 health zones by the Integrated Health Project (IHP), funded by the US Agency for International Development (USAID) with support from the President’s Malaria Initiative (PMI), and in 10 zones by The Global Fund to Fight AIDS, Tuberculosis and Malaria.

By 2015, the implementation of this package of interventions against malaria had contributed to saving the lives of at least 35,000 children under five in 78 health zones, according to the Spectrum Lives Saved Tool version 5.06, DRC 2013, an evidence-based tool for estimating the impact of interventions.

Evaluating a First-Line, Community-Based Treatment in Seven Health Zones

In addition, IHP is evaluating the acceptability and efficacy of artesunate suppositories -- a treatment new to DRC -- as a pre-referral first-line treatment for severe malaria in children under five at the integrated community case management (iCCM) site level. Findings of this evaluation, which is funded by USAID and conducted with PNLP, will indicate whether community health workers are capable of correct diagnosis and administration of the medicine and if the suppositories are effective in alleviating the illness long enough for a child to arrive at a referral site for intensive therapy.

Preliminary indications from the study suggest that using the suppository in young children is not only effective, but also well accepted by parents. Between May and June, 2015, 10 iCCM sites referred 21 children with warning signs of severe malaria after treating them with artesunate suppositories. The iCCM site of Lubuwa, in Kanda Kanda health zone, referred four of those cases -- including 20-month-old Ilunga.

“My son Ilunga vomited severely and then became lethargic,” says Ruth Mukadi, Ilunga’s mother:

I brought him to the Lubuwa community care site, where a community health worker gave him an artesunate suppository and referred us to a nurse at the health center 15 km away. The suppository resolved his lethargy, and after further treatment at the health center, my son was cured of malaria. He is now completely healthy, and I am overjoyed and grateful to the community health worker who treated him.

The evaluation is being conducted in 7 health zones, including 10 iCCM sites from the Kanda Kanda health zone in Kasaï Oriental. The first-line treatment could save many young lives.

Led by Management Sciences for Health with partners International Rescue Committee and Overseas Strategic Consulting, Ltd., IHP is working to improve the health of the Congolese people in 78 health zones in four provinces.