# \[e-drug\] Re: WHO on artemisine combination therapy

**URL:** https://talk.edrugplus.org/t/e-drug-re-who-on-artemisine-combination-therapy/14224
**Category:** e-drug
**Created:** [April 27, 2002, 1:47pm UTC](https://talk.edrugplus.org/t/e-drug-re-who-on-artemisine-combination-therapy/14224 "2002-04-27T13:47:26Z")
**Posts on this page:** 1
**Page:** 1

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### Author: ![mojoo](https://avatars.discourse-cdn.com/v4/letter/m/848f3c/32.png) [@mojoo](https://talk.edrugplus.org/u/mojoo)
#### Post date: [April 27, 2002, 1:47pm UTC](https://talk.edrugplus.org/t/e-drug-re-who-on-artemisine-combination-therapy/14224/1 "2002-04-27T13:47:26Z")

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E-drug: Re: WHO on artemisine combination therapy  
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In Kenya, the statistics show that a large proportion of Malaria  
deaths are in Children below Five and Pregnant women. I am  
delighted that there is a constant move to try and tackle this  
disease through various prevention and treatment options.  
However, I will continue to request the policy makers to remember  
to ensure that there are drug formulations appropriate for these  
children under five, even in resource challenged populations. Is  
there such a formulation for "COartem"? Not in Kenya. Has any one  
done a study that could quantify the extent of treatment  
failures(and resistance) attributed to inability of children under five  
to take tablets? (Even when they are crushed and dispersed in an  
appropriate liquid?). As one who works with children, I see the  
bewildered faces of parents, even among the very well educated  
ones, when asked to crush a quarter tablet of Folic Acid and  
disperse in some clean drinking water and give to their children as  
directed! (turning them into drug compounders at home!) The  
package insert for coartem gives the dosing schedule as follows  
5-\<15kg, one tablet at the time of initial diagnosis, and then 8,24  
and 48 hours thereafter(total course comprises 4 tablets) I  
remember voicing this concern of paediatric-appropriate  
formulations during an experts meeting on access to ARVs in  
Nairobi in July 2000 and I was a lone voice (One comment was that  
paediatric formulations are more costly than adult ones). I am  
probably opening up a pandoras box given the complex nature of  
treating the child which always involves a 3rd party(parent) So, my  
plea is for the policy makers to be conscious of the fact that they  
are dealing with a vulnerable group called children and their ability  
to take a drug is very much part of the treatment plan (does  
concordance apply in paediatrics?). Please say YES to the children  
in these matters!

Dr Atieno Ojoo  
Chief Pharmacist  
Gertrude's Garden Childrens' Hospital  
P O Box 42325-00100  
GPO, Nairobi  
Kenya  
Tel; 254 2 763474-7  
Fax; 254 2 763281  
Email; mojoo@gerties.org

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