Malaria treatment by using artemisinin in Indonesia.

Report on resistance of old malarial drug treatment (eg. chloroquine, sulphadoxine-pyrimethamine, and quinine) in the last decade has become concerned, affecting more than 25% provinces in Indonesia. Such a situation leads to a decision made by the Department of Health through commission meetings of malarial experts or known as komisi ahli malaria (KOMLI) to change the strategy of malaria drug treatment by using ACT (artemysinin combination treatment). As a treatment for any infection, a tendency of using drug combination has a strong role against resistance and preventing resistance to primary drug. Artemisinin is a sesquiterpene lactone of anti-malaria drug which is characterized by its blood schizonticides nature to P. falciparum and P. vivax. It has been developed from an ancient Chinese traditional drug for patient with fever, which is made from an extract of Artemesia annua L (qinghao) and has been used since thousand of years ago and was found by Chinese researchers in 1971. Artemisinin has been used for mild malaria as combination drug (ACT) and for severe malaria by using intra-vena or intra-muscular artesunate, or by using artemether for intra-muscular purpose only. Patients with malaria should have their blood slides to be examined on day 2, 3, and day 7, 14, 21, and 28. Patients who are not hospitalized and could not return on day 2 (48 hours following the initial treatment), may return on day 3. For those who got early or late treatment failure, another treatment should be provided. Treatment failure shall be defined in two criteria which are early and late treatment failure. The treatment for each patients with severe malaria should be performed as general treatment, symptomatic treatment, administration of anti-malaria drug, and treatment on complication.