Tanzania accommodated the malaria treatment policy change for uncomplicated malaria from sulphadoxine-pyrimethamine (SP) to ACT in October 2006 [Ministry of health and social welfare, National guideline for malaria diagnosis and treatment, 2006].
In July 2004, the first line antimalarial drug for uncomplicated falciparum malaria was changed from Sulfadoxine-pyrimethamine (SP) to artemisinin-based combination therapy (ACT) with the then only currently available fixed combination therapy: Artemether-Lumefantrine (AL) (3).
During the course of the study, first line treatment for uncomplicated malaria in The Gambia changed from chloroquine to the combination of chloroquine and SP. Since 2008, the recommended first line treatment for uncomplicated malaria has changed to artemether-lumefantrine (Coartem™, Norvatis Pharma, Basel Switzerland).
Tanzania introduced artemisinin-combination therapy [ACT] for uncomplicated malaria; however, the policy change is challenged by limited availability of ACTs due to high cost.
In 2008, the standard first-line antimalarial treatment regimen for uncomplicated malaria in the Gambia was changed from CQ-SP to co-artemether.
Tanzania's 2005 malaria treatment policy changed first-line treatment for uncomplicated malaria from sulfadoxine-pyrimethamine (SP) to artemisinin-based combination therapy (ACT --specifically ACT --specificallytrine (sometimes designACT --specifically
In 2007 Timor-Leste, a malaria endemic country, changed its Malaria Treatment Protocol for uncomplicated falciparum malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine.
By 2009, all 42 African malaria endemic countries had changed their policies to support ACT use for uncomplicated malaria.
In 2004 Sudan was among the first countries in Africa to change first and second line treatment policy for uncomplicated malaria from ineffective monotherapies to ACTs [ 21- 23].
These modifications marked the second change of first-line anti-malarial treatment for uncomplicated malaria (Ministerio da Saúde 2005); the first occurred after the country gained independence in 2002, at which time chloroquine (CQ) was replaced with SP Ministry of Health andd WHO 2002).
This argues against any change in the currently recommended standard of care for uncomplicated term pregnancy, i.e. vaginal delivery.
