A spoonful of sugar can help fight Malaria

A spoonful of sugar can help fight Malaria

One teaspoon of moistened sugar placed underneath the tongue of sick hypoglycaemic children – a simple solution to a serious problem.

Nearly 800,000 children die every year from malaria. In Africa, malaria combined with hypoglycaemia causes many of these children to die before they get to a health care facility, where they could access life saving intravenous treatment. A clinical trial conducted in Mali, with the support of Antenna Technologies, suggests that placing a spoonful of sugar under the child's tongue can be effective, and moreover much simpler than glucose.

Despite recent progress in the prevention and treatment of malaria, this tropical disease still affects more than 250 million people and kills nearly one million each year. With 85 to 90% of deaths occurring among children, it is the most vulnerable who pay the biggest price of the disease. The majority of these victims are under five years old and live in remote areas, mainly in Africa.

Children with hypoglycaemia, that is almost 20% of children with severe malaria, are three to four times more likely to die from the disease. Standard practice is to give an intravenous infusion of glucose, but this is often only accessible too late since it is administered at hard to reach health facilities. A clinical trial was carried out in Mali, in Sikasso Hospital, by the Department of Paediatrics and with the support of the Swiss International Cooperation and the Antenna Technologies team. This trial has identified a new method to correct hypoglycaemia and raise blood glucose. Results from this study have been published in the Malaria Journal.

By placing a teaspoon of sugar moistened with a few drops of water under the tongue of the child, even a child already in a state of coma, blood glucose levels were raised, providing what appears to be a simple first aid treatment. This easy treatment can be given by non professionals at home and during transportation to health centers, buying precious time, and saving many lives.

Proposed a long time ago by, among others, the French paediatrician Hubert Barennes, this simple method has not yet been applied due to a lack of trials. Trials have now been carried out. The bold action has been going against the idea prevalent among medics, to show that sugar does not necessarily have to be swallowed to act on glucose levels: by simple contact with the tissues in the oral cavity, particularly those under the tongue, a rapid elevation of blood sugar is observed, in fact even faster acting than if the sugar was swallowed.

In the race against time faced by children with severe malaria, evidence showing the benefits of administering sugar under the tongue can be life changing for the poorest regions where malaria hits the hardest. Now the challenge is to make this procedure known to tropical medicine specialists worldwide, and that the WHO and other health agencies include this procedure in their guidelines.