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Anti-malaria suppositories — medicines administered rectally — can save lives according to research published in The Lancet this week.

Malaria can be treated with pills and injections, but a key factor in the massive mortality inflicted on sub-Saharan Africa by the disease is the delay in administrating effective medicines. In the case of severe malaria, oral medications cannot be taken because patients can have difficulty swallowing. And for rural patients, the time taken to reach a health worker for injectable treatment can be fatal.

Researchers gave children in Malawi and adults in South Africa with moderately severe malaria either a suppository dose of the anti-malaria drug artesunate or an injection of quinine. They found that a single dose of artesunate administered rectally cleared malaria parasites faster than the injected quinine in both adults and children.

The suppositories don't cure malaria outright, however, and should be followed up as soon as possible with other medications. Nonetheless, they can be effective for patients that are too ill to take oral medication, especially when injections are not available. The drugs would offer protection for the period needed by patients to reach health facilities for additional treatment.

Link to research paper by Barnes et al in The Lancet*

Reference: The Lancet 363, 1598 (2004)

* Free registration to The Lancet is needed to view this document

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