WHO should accelerate, not stall, rectal artesunate deployment for pre-referral treatment of severe malaria

Journal article : Comment

Abstract:: The recent World Health Organization moratorium on rectal artesunate (RAS) for pre-referral treatment of severe childhood malaria is costing young lives. The decision was based on disappointing findings from a large observational study that provided RAS to community health workers with little training and supervision. This non-randomized, operational research has provided useful information to guide the implementation of RAS but is subject to bias and confounding and cannot be used to assess treatment effects. Parenteral artesunate reduces severe malaria mortality and a large body of evidence also shows RAS has lifesaving efficacy. There is now more than a decade of delay in conducting the necessary engagement and training required for successful deployment of RAS. Further delays will result in more preventable deaths.

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Institution:: University of Oxford
Division:: MSD
Department:: NDM
Sub department:: Tropical Medicine
Research group:: Centre for Global Health and Tropical Medicine; MORU Mahidol Oxford Tropical Medicine Research Unit
Role:: Author
ORCID:: 0000-0003-3197-9891

Institution:: University of Oxford
Division:: MSD
Department:: NDM
Sub department:: Tropical Medicine
Research group:: Centre for Global Health and Tropical Medicine; MORU Mahidol Oxford Tropical Medicine Research Unit
Role:: Author
ORCID:: 0000-0001-5524-0325

Institution:: University of Oxford
Division:: MSD
Department:: NDM
Sub department:: Tropical Medicine
Research group:: Centre for Global Health and Tropical Medicine; MORU Mahidol Oxford Tropical Medicine Research Unit
Role:: Author
ORCID:: 0000-0002-1897-1978

Institution:: University of Oxford
Division:: MSD
Department:: NDM
Sub department:: Tropical Medicine
Research group:: Centre for Global Health and Tropical Medicine; MORU Mahidol Oxford Tropical Medicine Research Unit
Role:: Author
ORCID:: 0000-0001-5190-2395

Publisher:: Oxford University Press
Journal:: Transactions of The Royal Society of Tropical Medicine and Hygiene More from this journal
Volume:: 117
Issue:: 7
Pages:: 536–538
Place of publication:: England
Publication date:: 2023-02-01
Acceptance date:: 2023-01-17
DOI:: 10.1093/trstmh/trad002
EISSN:: 1878-3503
ISSN:: 0035-9203

Copyright holder:: Peto et al.
Rights statement:: © The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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