Some causes of malaria treatment failure in Uganda

ABSTRACT

Malaria as a cause of fever is a common disease in Uganda and accounts for a high morbidity and mortality especially among the children. Being a well known common cause of fever; any fever is assumed to be due to malaria; which belief has erroneously led to the rampant self medication or prescription by medical personnel often in wrong doses and for wrong indications. When some of these fevers fail to respond to the antimalarials; it is not unusual to blame the failure on the presence of drug resistant malaria; often without confirming the diagnosis of malaria. Consequently; secondline or even reserve drugs for malaria are taken either through self medication or prescription by the medical personnel. The causes of malaria treatment failure are many and include the following misdiagnosis; multiple diagnoses; inadequate drug dosage; inactive drugs; undue change of medication; vomiting; fake symptoms; drugs not actually taken; reinfection and true drug resistance. From this presentation there are several reasons why malaria treatment failure is seen in Uganda; while the presence of malaria parasites resistant to drugs does occur in Uganda; it is by no means the commonest cause of the treatment failure