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    Malaria: Public Health Division, Directorate of Health Services Thiruvananthapuram June 2016

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    Ajan Mj
    This document summarizes information about malaria including symptoms, diagnosis, and treatment guidelines. It describes the typical symptoms of malaria like fever, chills, and headaches. It also outlines the gold standard for diagnosis of microscopy and the use of rapid diagnostic tests. Finally, it provides detailed treatment guidelines for both uncomplicated and severe malaria cases caused by P. vivax, P. falciparum, or mixed infections. It recommends the use of chloroquine, primaquine, ACT, quinine, and artemisinin derivatives depending on the type and severity of the malaria case.

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    Malaria: Public Health Division, Directorate of Health Services Thiruvananthapuram June 2016

    Uploaded by

    Ajan Mj
    29 views15 pages
    This document summarizes information about malaria including symptoms, diagnosis, and treatment guidelines. It describes the typical symptoms of malaria like fever, chills, and headaches. It also outlines the gold standard for diagnosis of microscopy and the use of rapid diagnostic tests. Finally, it provides detailed treatment guidelines for both uncomplicated and severe malaria cases caused by P. vivax, P. falciparum, or mixed infections. It recommends the use of chloroquine, primaquine, ACT, quinine, and artemisinin derivatives depending on the type and severity of the malaria case.

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    malaria guidelines

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    Malaria

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    This document summarizes information about malaria including symptoms, diagnosis, and treatment guidelines. It describes the typical symptoms of malaria like fever, chills, and headaches. It also outlines the gold standard for diagnosis of microscopy and the use of rapid diagnostic tests. Finally, it provides detailed treatment guidelines for both uncomplicated and severe malaria cases caused by P. vivax, P. falciparum, or mixed infections. It recommends the use of chloroquine, primaquine, ACT, quinine, and artemisinin derivatives depending on the type and severity of the malaria case.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    29 views15 pages

    Malaria: Public Health Division, Directorate of Health Services Thiruvananthapuram June 2016

    Uploaded by

    Ajan Mj
    This document summarizes information about malaria including symptoms, diagnosis, and treatment guidelines. It describes the typical symptoms of malaria like fever, chills, and headaches. It also outlines the gold standard for diagnosis of microscopy and the use of rapid diagnostic tests. Finally, it provides detailed treatment guidelines for both uncomplicated and severe malaria cases caused by P. vivax, P. falciparum, or mixed infections. It recommends the use of chloroquine, primaquine, ACT, quinine, and artemisinin derivatives depending on the type and severity of the malaria case.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 15

    Malaria

    Public Health Division, Directorate of Health Services


    Thiruvananthapuram
    June 2016
    1
    MALARIA
    Symptoms
    • Fever
    • Chills
    • Sweats
    • Headaches
    • Nausea and vomiting
    • Body aches
    • General malaise

    2
    3
    Diagnosis
    Microscopy
    • gold standard
    • The sensitivity is high.
    • quantify the parasite load.
    • distinguish the various species
    Bivalent RDT
    • Detection of circulating parasite antigens.
    • Detection of both Plasmodium vivax and P. falciparum
    at locations where microscopy results are not
    obtainable within 24 hours of sample collection.

    4
    Malaria- Treatment
    (National drug Policy -2013)
    • No Presumptive Treatment is recommended
    • All fever cases suspected to be malaria should be
    investigated by microscopy or RDT.
    • Provide full course treatment as SDA (Supervised
    Drug Administration) for all patients.
    • Use appropriate regimen for the type of parasite
    • Vivax Malaria
    – CQ for 3 days {600mg (4 tablets) on 1st day, 600
    mg (4 tablets) on 2nd day and 300mg (2 tablets) on 3rd
    day} + Primaquine 15mg daily for 14 days

    5
    • Falciparum Malaria
    • – ACT for 3 days + Primaquine 45mg on second day
    • • Mixed Malaria
    • – ACT for 3 days + PQ- 15mg/day for 14 days from 2nd day
    onwards.
    • Note: (1) Primaquine should not be used in Pregnancy,
    Infancy and G6PD deficiency
    • (2) ACT is Artemesinin Combination Therapy (Artesunate
    for 3 days + Sulphadoxine‐Pyrimethamine for 1 day)
    • (3) Primaquine and Sulphadoxine‐Pyrimethamine should
    not be given on the same day.
    • Hence avoid PQ on the first day of ACT regimen
    • (4) ACT not given during the 1st TM of pregnancy but given
    during 2nd and 3rd TMs.
    • Use Quinine during the 1st TM.

    6
    Drug schedule for treatment of
    malaria under NVBDCP
    • Treatment of P.vivax cases
    • 1. Chloroquine: 25 mg/kg body weight divided
    over three days i.e. 10mg/kg on day 1,
    10mg/kg on day 2 and 5mg/kg on day 3.
    • 2. Primaquine: 0.25 mg/kg body weight daily
    for 14 days.

    7
    8
    Treatment of uncomplicated
    P.falciparum cases
    • 1. Artemisinin based Combination Therapy
    (ACT)*
    • Artesunate 4 mg/kg body weight daily for 3
    days Plus
    • Sulfadoxine (25 mg/kg body weight) .
    Pyrimethamine (1.25 mg/kg body weight) on first
    day plus
    • Single dose of Primaquine 0.75 mg/Kg bw on 2nd
    day
    * ACT not given in 1st TM of pregnancy.

    9
    10
    Treatment of uncomplicated
    P.falciparum cases in pregnancy
    • 1st TM : Quinine salt 10mg/kg tds x 7 days.
    • Note: Quinine may induce hypoglycemia;
    pregnant women should not take quinine on
    empty stomach and should eat regularly, while
    on quinine treatment.
    • 2nd & 3rd TM: ACT as per dosage given above.
    • Treatment of mixed infections (PV &PF)
    • Full course of ACT &PQ 0.25 mg/kg x 14 days.
    11
    Treatment of severe malaria cases
    • Emergency and treatment based on severity,
    associated complications & decision of
    treating physician.
    • Artesunate: 2.4 mg/kg IV or IM given on
    admission (time = 0 h); then at 12 h and 24 h
    & then once a day. (or)
    • Artemether: 3.2 mg/kg IM given on admission
    and then 1.6 mg/kg /day. (or)
    • Arteether: 150 mg IM daily for 3 days in adults
    (not for children). (or)
    12
    • Quinine: 20 mg/kg* on admission (IV infusion or
    divided IM injection) followed by maintenance
    dose of 10 mg/kg 8 hourly.
    • The infusion rate should not exceed 5 mg salt/kg
    b.w/hour.
    • *loading dose of 20mg /kg Quinine on admission
    not given if the patient has already received
    quinine or if the clinician feels inappropriate.)
    • Note:
    • The parenteral treatment in severe malaria cases
    should be given for minimum of 24 hours.
    • Once started irrespective of the patient’s ability
    to tolerate oral medication earlier, not given for
    more than 24 hours. 13
    • After parenteral artemisinin therapy, patients
    should receive a full course of oral ACT for 3
    days.
    • Patients who received parenteral Quinine
    therapy should receive:
    • Oral Quinine 10 mg/kg b.w 3 tds*7 days
    (including the days when parenteral Quinine
    was administered) plus Doxycycline 3 mg/kg
    b.w once a day or Clindamycin 10 mg/kg bw
    12‐hourly for 7 days
    • (Doxycycline is contraindicated in pregnancy
    & children<8 years of age). (or)
    • ACT as described 14
    Contacts and Clarifications
    • For all queries about phone numbers, email etc of
    concerned officials of Health Services like DMO,
    District Surveillance Officer (DSO) District
    Programme Manager (DPM), RCH Officer
    (RCHO)of your district, State Officials,
    institutions, specialists, etc, please call
    • 24 x 7 NHM Health Services helpline DISHA on

    • 0471-2552056 ( Normal call, any line)


    • 1056 (toll free from BSNL Lines)
    15

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