MINIMAX - Minimal drug use for maximal effect

Effectiveness of introducing and promoting diagnostics and paediatric-dosage pre-packed medicines for acute febrile illnesses and diarrhoea to private sector drug shops in Uganda

“Fever” is the most common symptom of the diseases that kill 10 million children per year in families around the world. The main killer diseases malaria and pneumonia both present with fever and rapid breathing and these symptoms overlap in one third of sick children in Ugandan health centres, (see Figure below). Fever also overlaps with diarrhoea, the third killer disease. Without diagnostic tests health workers do not know which drug to give to one child out of three. In Uganda where more than 10% of children die before their fifth birthday we have found that many children dying from pneumonia had indeed first been treated with malaria drugs. And Oral Rehydration Solution including zinc is rarely given in fever treatment despite the symptom overlap with fever.

Many sick children do not have access to good quality health services. In rural Uganda we found that two thirds of febrile children were treated at home with drugs from informal drug sales in the ubiquitous private shops. However, children mostly get old and ineffective drugs from these small shops, while the drug resistance is mounting …. Yet new and effective drugs exist, but only miles away in the closest public health center. Meanwhile the nearby private sector provider is disregarded, even though this is where most mothers bring their sick children!

The objective of the Minimax project is to assess the feasibility and effects of introducing and promoting paediatric-dosage pre-packed drugs for acute febrile illnesses (malaria and pneumonia) and/or diarrhoea in private sector outlets in order to contribute to rational use of drugs and child survival. In Uganda under collaboration between Makerere University (Department of Community Health and Behavioural Sciences), the Karolinska Institutet (Sweden) and the Swiss anti-malarial drug development giant Medicines for Malaria Venture, we will specifically:


MINIMAX publication

Awor P, Wamani H, Bwire G, Jagoe G, Peterson S. Private Sector Drug Shops in Integrated Community Case Management of Malaria, Pneumonia, and Diarrhea in Children in Uganda. Am J Trop Med Hyg. 2012;87(5):92-96.

Here you can find more information on Makerere University and Extending AMFm to Integrated Case Management of Malaria, Pneumonia and Diarrhoea in Drug Shops in Uganda.