Experts in the field of malaria research have expressed concern that the frequent use of anti-malaria drugs to treat recurring fevers without proper diagnosis is contributing to the rise in drug resistance.

Malariologists, who specialize in the study, treatment, and prevention of malaria, have criticized the lack of adherence to treatment guidelines.

They have stressed the importance of accurate diagnosis before starting treatment in commemoration of World Malaria Day, celebrated annually on April 25. This year’s theme, ‘Accelerating the fight against malaria for a more equitable world,’ aims to achieve the 2030 goal of reducing malaria cases through equitable, gender-responsive, and human-rights-based strategies.

Wakadaily learnt that, the World Health Organization (WHO), malaria is a serious disease that can cause mild to severe symptoms and is transmitted through infected mosquitoes, blood transfusions, and contaminated needles.

In 2022, there were 249 million malaria cases and 608,000 deaths globally, with Africa bearing the highest burden. Nigeria alone accounts for 27% of the global malaria burden.

The WHO recommends Artemisinin-based combination therapy for treating uncomplicated malaria, but resistance to this treatment has been reported in some countries, including Nigeria.

To address this issue, the WHO has launched a strategy to monitor and regulate the efficacy of anti-malaria drugs and limit resistance through proactive measures.

Although there has been a slight decrease in the effectiveness of ACT, it remains 95% effective and reliable, according to Professor Olusegun Ademowo of the University of Ibadan. He emphasized that ACT is still the primary treatment for malaria and its dual-drug combination and diverse mechanisms of action help maintain its efficacy.

Despite concerns about rising resistance, efforts are underway to enhance ACT with a long-acting drug to combat resistance effectively.

Ademowo restated, “We have to be very conscious when we talk of resistance to malaria. Many times, what people call resistance to malaria is not resistance but because of some other pathogens that the individuals are also infected with which could be viruses or bacteria. For that reason, it is now very important for people to start looking in the direction of co-infections, which is very common. These other pathogens have other symptoms like that of malaria, so these are big issues that must be addressed.

“This means that in treating malaria, we have to be very cautious because we have to ascertain that what you have is malaria infection and not just something else.

“Sometimes, we treat malaria when it is not malaria and sometimes we treat malaria alone leaving the other co-infecting pathogen.”

The Don praised the WHO and other researchers for their efforts in decreasing malaria fatalities in the country. However, he stressed the importance of expanding on the accomplishments made by ensuring proper diagnosis, treatment, and monitoring of malaria cases.

Ademowo further highlighted, “One of the things that escalate resistance to malaria or even other pathogens is when people don’t comply with the usage of their drugs. Someone who is supposed to take a drug for three days takes it for one or two days because they have had relief from the symptoms. This is very common and studies have shown that people don’t complete the usage of their drugs and treatment for malaria is not an exemption.”

The don advocated a comprehensive approach to preventing malaria infection, emphasising the need to eliminate contact between mosquitoes and humans, which are the vectors for the disease.

“If you have a fever that is not going, ensure that you carry out appropriate tests to confirm that it is malaria or not before you start blaming it on malaria alone. A persisting fever that is being treated as malaria whereas it is not malaria means that the causative agent would continue to ravage and damage the person’s body,” the pharmacist Mentioned.

Ademowo suggested that the government should step in to address the increasing prices of malaria treatment by offering discounted rates for children and pregnant women.

Meanwhile, Professor Sulayman Balogun pointed out that the country is currently grappling with challenges of malaria recurrence and resistance to anti-malaria medications.

He explained that repeated exposure to the malaria vector leads to the recurrence of the disease, while resistance to drugs occurs when symptoms persist despite treatment.

Additionally, he highlighted that environmental factors and human behavior also play a role in these challenges.

Balogun mentioned, “Virtually all known anti-malaria drugs, malaria has developed resistance to it and that was led to the ACT that Nigeria adopted in 2005. The parasite, plasmodium feeds on blood cells to survive but because it wants to protect itself from danger, it mutates genetically such that the drug introduced will no longer work and (the parasite) continues to multiply in the blood cells of its host. That way, we say resistance has developed.”

The pharmacist debunked the notion that all fevers are malaria, calling for laboratory diagnosis before the diagnosis and treatment of malaria were done.

He also stated that the non-compliance with treatment regimen and substandard drugs contributes to anti-malaria resistance.

The researcher mentioned, “We assume all fever is malaria, whether we do a diagnosis or not and a lot of irrational use of anti-malaria drugs will promote resistance.

“Again, non-compliance with treatment is done a lot. We go to the doctor and an anti-malaria drug is prescribed for three days and after taking the first two doses the first day and feeling relieved, we discontinue usage and this will promote and predispose the parasite to drug resistance.”

In order to prevent anti-malaria resistance, Balogun stressed the importance of conducting laboratory tests before starting malaria treatment to guarantee accurate diagnosis and proper medication administration.

He also promoted the use of preventive measures such as sleeping under insecticide-treated nets, using insecticide sprays, and putting nets on windows and doors to repel mosquitoes. Additionally, he cautioned against staying in dark areas where mosquitoes are prevalent at night.

Balogun noted that the government had implemented preventive medications for pregnant women, children under five, and individuals with sickle cell disease during malaria outbreaks.