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Executive summary

executive summary

Malaria case management remains a vital component of the malaria control strategies.
This entails early diagnosis and prompt treatment with effective antimalarial medicines.
The WHO Guidelines for the treatment of malaria, which were first published in 2006,
provide global, evidence-based recommendations on the case management of malaria,
targeted mainly at policy-makers at country level, providing a framework for the
development of specific and more detailed national treatment protocols that take into
account local antimalarial drug resistance patterns and health service capacity in the
country. This second edition of the guidelines revisits the recommendations based on
updated evidence. The same presentation format from the first edition has been mainly
kept based on feedback from the end-users. A summary of the key recommendations
provided in these guidelines is presented below.

box 1. recommendations unchanged from the first edition of the Guidelines (2006)

treatment of uncomplicated P. falciParum malaria

 Artemisinin-based combination therapies (ACTs) are the recommended treatments for
uncomplicated P. falciparum malaria.

 The following ACTs are recommended:
■ artemether plus lumefantrine, artesunate plus amodiaquine, artesunate plus mefloquine, and artesunate
plus sulfadoxine-pyrimethamine.
 The choice of ACT in a country or region will be based on the level of resistance of the partner
medicine in the combination.
 Artemisinin and its derivatives should not be used as monotherapy.
 Second-line antimalarial treatment:
■ alternative ACT known to be effective in the region;
■ artesunate plus tetracycline or doxycycline or clindamycin; any of these combinations to be given for
7 days;
■ quinine plus tetracycline or doxycycline or clindamycin; any of these combinations should be given for 7
days.
treatment of uncomplicated P. falciParum malaria in special risk Groups

 Pregnancy
First trimester:
■ quinine plus clindamycin to be given for 7 days (artesunate plus clindamycin for 7 days is indicated if this
treatment fails);
■ an ACT is indicated only if this is the only treatment immediately available, or if treatment with 7-day
quinine plus clindamycin fails or uncertainty of compliance with a 7-day treatment.

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