Welcome to Amayeza Information Centre
We are an independant medicine information centre that aims to provide reliable, accurate, objective, and up-to-date information on medicine to pharmacists and other health care professionals across South Africa.
Please note that our services are subscription-based. In order for you to benefit from our up-to-date medicine information, you will need to be a subscriber of Amayeza Information Services. For more information regarding subscriptions, click here
The word “Amayeza” means “Medicine” in the Xhosa language.
Malaria – Update
Information courtesy of the National Institute for Communicable Diseases (NICD):
The early increase in malaria cases has continued in Limpopo and Mpumalanga Provinces, including cases being reported from the Kruger National Park and some of the surrounding private lodges. The very mild winter conditions experienced in the region has been favourable to ongoing mosquito breeding. The annual indoor residual spraying programme is due to commence shortly and will hopefully result in a decrease in transmission.
There should be heightened awareness for malaria in any person living in or with recent travel to a malaria area who presents with a fever or flu- like illness. This is especially important to note given a prolonged influenza season and overlapping symptoms, and a number of recent misdiagnoses of malaria as influenza. Urgent malaria tests are required, and repeated if negative.
The 2017 National Malaria Treatment Guidelines and 2017 Guidelines for the Prevention of Malaria (final draft version) can be accessed on the NICD website http://www.nicd.ac.za/
Artesunate has replaced quinine as the treatment of choice for severe malaria and will be available from October 2017 as the registered product GARSUN®. The section 21 application and reporting is no longer required. Compared to parenteral quinine, artesunate reduces death from severe malaria by 39% in adults and 24% in children. Its advantages include: 1) rapid action with activity from early to late stages of the parasite life cycle, preventing the complication-causing sequestration of parasite-infected red cells, 2) administration as a slow intravenous injection over several minutes rather than requiring a slow rate-controlled intravenous infusion over 4-6 hours, 3) a favourable safety profile and without causing hypoglycaemia, and 4) not requiring dosage adjustment in renal failure. Artesunate can be used in all trimesters of pregnancy (see malaria guidelines for discussion), and there is no lower age or weight limit. It can also be administered intramuscularly if intravenous administration not possible. The dosage of artesunate is 2.4mg/kg for patients weighing > 20kg – stat, and at 12 and 24 hours and then daily until patients can take oral treatment. For patients weighing < 20kg, the dose is 3mg/kg stat following the same schedule. Artesunate must be given for at least 24 hours (i.e. 3 doses), and should be followed by a full course of artemether-lumefantrine (Coartem®) to avoid recrudescence.
Further details on administration can be found at https://www.mmv.org/access/tool-kits/injectable-artesunate-tool-kit
Pharmacists now have an essential role in malaria prevention
Although there have been good control efforts, malaria remains a major health burden in South Africa.Malaria chemoprophylaxis (prevention) helps reduce the chances of travellers becoming ill with malaria.
Doxycycline, a malaria prophylaxis medication has now been down-scheduled for the pharmacist to dispense provided the use and intention is for malaria prophylaxis for travellers 8 years and older for a period not longer than 4 months.
For more information regarding the downscheduling, please refer to: http://www.gpwonline.co.za/Gazettes/Gazettes/39815_15-3_Health.pdf
For more information regarding malaria: http://www.santhnet.co.za/index.php/travel-health-advice/2015-02-04-01-09-55/malaria-advice-for-travellers/item/277-malaria.html
RABIES IN JOHANNESBURG
Rabies was confirmed in two jackals in Muldersdrift and the other in the Lanseria area this week. The National Institute for Communicable Diseases (NICD) advises not to touch any wild animals especially jackals that appear tame.
Preventative measures include the following: Washing of the wound very well for at least 10 minutes with water or soap to wash out the virus, and consult your doctor immediately for rabies post exposure prophylaxis.
For more information :http://www.nicd.ac.za/?page=alerts&id=5&rid=670
SWITCH FROM T-OPV TO B-OPV
As part of the global Polio Eradication Initiative, the polio endgame strategic plan (2013-2018) was formulated in 2012. One of the key objectives is to remove OPV and thereby eliminate the risk of Vaccine Associated Paralytic Polio (VAPP). This however has to be done in stages.
All trivalent OPV (t-OPV) will be replaced with bivalent OPV (b-OPV) and this switch must be synchronised worldwide to minimise the risk of Vaccine-derived polio virus infection with type 2.
The switch date in South Africa is April 20th and we are fast approaching this date! If you stock any OPV and have not been contacted by the Department of Health in your area, please contact the coordinator in your area as soon as possible so that arrangements can be made to collect your t-OPC stock and replace it with b-OPV.
THIS IS A MATTER OF INTERNATIONAL IMPORTANCE!
South African Society of Travel Medicine (SASTM) Publications:
Beyond Childhood Vaccination: http://www.sastm.org.za/sastm_publication.php?id=34
A Guide to the Practice of Travel Medicine
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