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The jury is still out on AS+AQ anti-malaria drugs

January 23, 2015 By Patrick J. Kamara

Dr. Abu bakar Fofanah - Minister of Health and Sanitation
Dr. Abu bakar Fofanah – Minister of Health and Sanitation

The Mass Drug Administration (MDA) of Artesunate and Amodiaquine (AS+AQ) in the Western Area and some parts of the provinces could yield very good fruits in the fight against the dreaded Ebola virus, which has killed more than 2,700 to date.

Almost eight months into the worst Ebola outbreak in history, many people were anticipating that the free distribution of the anti-malaria drugs would have come at an earlier stage as malaria symptoms, including high fever, dizziness, headaches, muscle aches and fatigue, are akin to some of the early stages of Ebola symptoms.

The distribution of the drugs was jointly founded by the government of Sierra Leone and Medecine Sans Frontieres (MSF) in the Western Area, and the United Nations Children’s Emergency Fund (UNICEF). The second phase of the mass drug administration did not only target the Western Area, but epicenter districts – Bombali, Kambia, Koinadugu, Moyamba, Port Loko and Tonkolili.

Although Registrar of the Pharmacy Board of Sierra Leone, Wiltshire Johnson Jr. opines that only 3% of those who took the drugs during the first phase of distribution complained side effects, Concord Times can authoritatively reveal that a far greater percentage of those who took the anti-malarial drugs complained of side effects.

The persistent complaints of terrible side effects couldn’t be unconnected with poor sensitization by volunteers who were recruited to distribute the drugs.

The World Health Organization (WHO) reportedly did recommend in December last year the distribution of free AS+AQ in epicenter districts and the Western Rural and Urban Areas. According to WHO, Sierra Leone has the fifth highest prevalence of malaria globally, with a national prevalence of 33% in children under the age of five years.

National health officials argued that the objective of the drugs distribution was to reduce the prevalence of malaria, especially among children and pregnant women, and to improve diagnostic accuracy in diagnosis of suspected Ebola cases by reducing the disease most likely to be mistaken for Ebola.

The second phase of the free distribution of AS+AQ commenced from Friday, 16 January to Monday, 19 January, 2015. The volunteers spent two days going door-to-door to sensitize communities on how to take the medication properly and gave instructions for reporting any side effects.

This was lacking during the first phase of distribution, causing many people to take more pills at a time than required, thus leaving some unconscious, restless, and few reported deaths.

Musu Makalay, a retired nurse and resident of Circular Road, Freetown, explained the ordeal her children went through when they took the drugs in her absence.

“I was not at home when the volunteers arrived. I came home later and realized that the AS+AQ had been given to my children without the appropriate explanation. My last child, who is just five years, went into coma as a result. The volunteers knowingly or unknowingly gave him the tabs meant for adult,” she said.

She revealed her children survived the scare, although she admitted she feared for the worse.

Others vowed never to take the drugs, apparently out of experience.

An elderly man at Benjamin Lane, Willie Lionel Branche, whose wife went unconscious for three days after taking the drugs, said government’s decision to distribute the medicine was a good one but blamed the near fatality on untrained volunteers. He revealed that he refused to take the drugs during the second distribution phase because of his previous experience.

Arthur Ben Tucker is a journalist who works for the New People newspaper. He said he feared he had contracted Ebola after he took the AS+AQ drug. “When I took the drugs it was just like moving from the frying pan to the fire. I became confused and did not talk to anybody, least they would call 117,” he said, adding that he skipped work for a week as he battled with terrible side effects of the drugs.

He too blamed volunteers for his ordeal. “I was misdirected by the volunteers, instead of one tab per day I took four, two in the morning and at night,” Tucker explained.

Meanwhile, several communities in the Western Area claim they didn’t receive the AS+AQ drugs. Residents of upper Dwarzark Farm, Gloucester, Tree-Planting, Leicester and Moyieba all say volunteers did not supply them the drugs.

For now, the jury is still out as to whether in fact the drugs’ administration provided much-needed impetus to defeat the Ebola virus, as health officials had hoped.

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