4 years ago, a heated debate concerning malaria prophylaxis had been triggered on www.malariaworld.org. It concerned the very promising results obtained by Dr Patrick Ogwang, with an herbal product called Artavol, he had developed with the Ministry of Health in Uganda. Peer reviewed papers and press releases are easily found on internet.
Merlin Willcox, UK, Honorary Secretary of RITAM, questioned the validity of the therapeutic and prophylactic results obtained by the research team from Uganda; that like many other studies they were poorly designed with fundamental flaws. And that it would be unethical to promote Artemisia teas at the expense of ACTs in young children.
Dr Willcox is right in stating that no large scale, randomized, double blind clinical trials confirming the efficiency of Artemisia plants against malaria are available. Indeed, they are forbidden by WHO. Only clinical trials with ACTs have been run in high numbers. OXFAM and others even claim that Africans are guinea pigs for pills or vaccines from BigpharmaWHO.
Fortunately, some African medical doctors have decided not to obey the ludicrous veto of WHO Geneva and obtained the authorization of their health authorities to run clinical trials, small or large scale, with Artemisia annua or Artemisia afra: in Cameroon, in Mali, in Kenya, in RDCongo, in Senegal, in The Gambia, in Benin, in Ethiopia, in Tanzania, in Uganda, in Mozambique. They all confirm a cure rate of >95 % for uncomplicated malaria, much higher than for ACTs.
This all was confirmed by a large scale trial in the province of Maniema, RDCongo of Artemisia annua and afra vs ASAQ: 1000 patients, randomized, double blind. The herbal treatment was in all aspects superior: for fever clearance, parasitemia clearance, gametocytemia clearance, with no adverse effects and a virtual absence of recurrence on day 28 (see www.malariaworld.org “Breaking news from clinical trials with Artemisia plants in Maniema”). The trial included 465 children from 2-5 years of age.
But these were all symptomatic patients and the question of the efficacy of Artemisia tea infusions on asymptomatic carriers remained open. Dr Jérôme Munyangi has now completed a first randomized trial with 2x100 primary school children in the province of Maniema. The objective was to study the impact of a prophylactic treatment of 3 cups/week Artemisia annua infusion. The results are overwhelming. In the second and third month of the treatment parasitemia and gametocytemia have completely disappeared in the Artemisia arm, but in the control arm the parasite carriage remains constant over the 3 months (see pdf attached).
The seminal discovery in this small trial, which will be repeated in more schools, is of course that the prophylactic effect is evident, but more important: that the treated children will not transmit gametocytes to mosquitoes biting them.
An important side effect which was noticed is the decrease in anemia in the treated arm. Anemia is a consequence not only of symptomatic malaria, but also of asymptomatic carriage.
A recent review paper financed by the Bill&Melinda Gates Foundation and by the European Community’s 7th Framework Program addresses this critical issue.
Chen I, Clarke SE, Gosling R, Hamainza B, Killeen G, Magill A, et al. (2016) “Asymptomatic” Malaria: A Chronic and Debilitating Infection That Should Be Treated. PLoS Med 13(1): e1001942. doi:10.1371/journal.pmed.1001942
Their answer to the question: Are afebrile malaria infections truly asymptomatic, benign, or even beneficial to the individual? The evidence suggests the contrary. So-called asymptomatic malaria infections are associated with recurrent episodes of symptomatic parasitemia, chronic anemia, maternal and neonatal mortality, co-infection with invasive bacterial disease, cognitive impairment, and ongoing transmission of the parasite. They have significant health and societal consequences.
Typhoid fever and salmonellosis kill more than 100 000 people per year in Sub-Saharan Africa. These diseases are directly linked to a weakened immune system, by symptomatic and asymptomatic malaria. One of our partners has seen a significant preventive, not curative effect, of regular Artemisia tea drinking on typhoid fever in a community of several hundred people in Burundi. So far, we had no good explanation for this observation.
A.J Cunnington, JB de Souza, RM Walther EM Riley. Malaria impairs resistance to Salmonella. Nat Med 2012 18(1) 120-127
This smallscale trial, financed by M4L, confirming the excellent prophylactic properties of Artemisia infusions is a breakthrough. It needs to be continued in RDCongo and elsewhere.