Artesunate – amodiaquine combination therapy for falciparum malaria in young Gabonese children

BACKGROUND: Artesunate-amodiaquine combination for the treatment of childhood malaria is one of the artemisinin combination therapies (ACTs) recommended by National authorities in many African countries today. Effectiveness data on this combination in young children is scarce. METHODS: The effectiveness of three daily doses of artesunate plus amodiaquine combination given unsupervised (n = 32), compared with the efficacy when given under full supervision (n = 29) to children with falciparum malaria were assessed in an unrandomized study. RESULTS: 61 patients analysed revealed a PCR-corrected day-28 cure rate of 86 % (25 of 29 patients; CI 69 – 95 %) in the supervised group and 63 % (20 of 32 patients; CI 45 – 77 %) in the unsupervised group. The difference in outcome between both groups was statistically significant (p = 0.04). No severe adverse events were reported. CONCLUSION: The effectiveness of this short course regimen in young children with falciparum malaria could be augmented by increased adherence and improved formulation

'It is me who eats, to nourish him': a mixed-method study of breastfeeding in post-earthquake Haiti.

In Haiti, initiation of breastfeeding is high, but early mixed feeding is the norm. In a situation of crisis, mothers' worries about insufficiency of breast milk, disruption of social networks and free unmonitored distribution of breast milk substitutes impact feeding practices. This study was conducted to explore the attitudes, practices and understandings of breastfeeding in the post-earthquake situation in Haiti. A mixed-method study was conducted in Léogâne, Haiti, a town close to the epicentre of the 2010 earthquake. In a household survey, 1131 mothers of children under 24 months were interviewed about feeding practices. In the quantitative component, we conducted 25 in-depth interviews and seven focus group discussions with mothers, grandmothers, traditional birth attendants, fathers and health care professionals. Mothers described breastfeeding as a challenging responsibility to ensure the infants' health. They understood breast milk as a dynamic substance, the quality of which would deteriorate if the mother's diet was poor or if the mother was afflicted with a psychosocial condition called move san or colere, 'bad blood'. To protect the child in these situations, early supplementary feeding is introduced. Only 20% of informants exclusively breastfed infants under 6 months. Because of a lack of confidence in the quality of breast milk, Haitian mothers tend to wean children earlier. The abiding concerns of Haitian mothers over the quality of their breast milk suggest a number of ways - such as dietary advice - that post-earthquake aid agencies could enhance breastfeeding support