epidemiology of Malaria (see discription for treatment)

Principles of Treatment

Treatment of malaria depends on the following factors:

Type of infection.

Severity of infection.

Status of the host.

Associated conditions/ diseases.

Type of infection: Treatment obviously depends on the type of infection. Patients with P. falciparum malaria should be evaluated thoroughly in view of potential seriousness of the disease and possibility of resistance to anti malarial drugs.

P. vivax: Only Chloroquine 25 mg/kg + Primaquine for 14 days.

P. falciparum: Treat depending on severity & sensitivity; in most countries, artimisinin based combination therapy is recommended by the authorities. Primaquine as gametocytocidal is also recommended to prevent spread.

Mixed infections: Blood schizonticides as for P. falciparum and Primaquine as for P. vivax.

Severity of infection: All patients with malaria should be carefully and thoroughly assessed for complications of malaria. Acute, life-threatening complications occur only in P. falciparum malaria. Malaria is probably the only disease of its kind that can be easily treated in just 3 days, yet if the diagnosis and proper treatment are delayed, it can kill the patient very quickly and easily.

All cases of severe malaria should be presumed to have P. falciparum malaria or treated as such.

If there is any uncertainty about the drug sensitivity of the parasite, it is safer to treat these cases as chloroquine resistant malaria with drugs like quinine or artemisinin.

All cases of severe malaria should be admitted to the hospital for proper evaluation, treatment and monitoring.

All cases of severe malaria should be treated with injectable antimalarials (quinine, artemisinin derivatives) so as to ensure adequate absorption and plasma drug levels. Once the patientg is able to take oral medications, artimisinin combination therapy must be used as per recommendations.

All associated conditions should be carefully assessed and treated.