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Injectable artesunate is supplied mostly at centralised health facilities such as regional hospitals.
Today, this is injectable artesunate for treatment at facilities and rectal artesunate to buy time before patients reach facilities".
A Médecins Sans Frontières trial found treatment with the new drug, injectable artesunate, reduced the risk of death by 39% in adults and 24% in children.
While injectable artesunate can only be administered in health clinics and hospitals, health workers like Nure can deliver a different form of the drug rectally.
One manufacturer of injectable artesunate, Guilin Pharmaceuticals, achieved WHO pre-qualification status in 2010 [ 145].
In a recent study conducted in Gabon and Ghana, delayed hemolysis occurred in 7% of children treated with injectable artesunate, 5 which is consistent with our findings.
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In most malaria endemic countries injectable formulations of artesunate and quinine and the necessary skill to give them are mainly concentrated in large healthcare facilities.
In rural settings without access to injectable antimalarials, rectal artesunate probably reduces mortality in young children (6 to 72 months old) being transported to hospital for further care.
In rural areas without access to injectable antimalarials rectal artesunate provided before transfer to a referral facility probably reduces mortality in severely ill young children compared to referral without treatment.
13, 14 ACTs have been free in Laos for all ages in the public sector since 2005, and artemisinin-based monotherapies have been withdrawn since 2008, except artesunate injectables that are, as recommended by WHO, the optimal treatment of severe malaria.
Individual or cluster-randomized controlled trials comparing pre-referral rectal artesunate with placebo or injectable antimalarials in children and children with severe malaria.
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