Rectal artesunate as pre-referral treatment for severe malaria in sub-Saharan Africa: still a long way to go

Abstract

Rectal artesunate for pre-referral treatment of severe malaria has been reported as an effective malaria intervention to substantially reduce the risk of death and permanent disability among children younger than 5 years in sub-Saharan Africa, by delaying the progression of disease severity as children seek to access health facilities for adequate treatment.1 However, although well accepted as an intervention,2 reported findings have raised concerns over the effectiveness of rectal artesunate in real-life conditions, which are often associated with shortcomings in terms of referral and quality of care.