Page 13 - 80 guidelines for the treatment of malaria_opt

Executive summary

box 2. additional recommendations in the second edition of the Guidelines (2010)

malaria diaGnosis

 Prompt parasitological confirmation by microscopy or alternatively by RDTs is recommended
in all patients suspected of malaria before treatment is started.

 Treatment solely on the basis of clinical suspicion should only be considered when a
parasitological diagnosis is not accessible.

treatment of uncomplicated P. falciParum malaria
 Artemisinin-based combination therapies should be used in preference to sulfadoxine-
pyrimethamine (SP) plus amodiaquine (AQ) for the treatment of uncomplicated P. falciparum
malaria.
Strong recommendation, moderate quality evidence.

 ACTs should include at least 3 days of treatment with an artemisinin derivative.
Strong recommendation, high quality evidence.

 Dihydroartemisinin plus piperaquine (DHA+PPQ) is an option for the first-line treatment of
uncomplicated P. falciparum malaria worldwide.
Strong recommendation, high quality evidence.
 Addition of a single dose primaquine (0.75 mg/kg) to ACT treatment for uncomplicated falciparum
malaria as an antigametocyte medicine, particularly as a component of pre-elimination or an
elimination programme.

treatment of severe P. falciParum malaria

 Intravenous (IV) artesunate should be used in preference to quinine for the treatment of severe
P. falciparum malaria in adults.
Strong recommendation, high quality evidence.

treatment of uncomplicated P. vivax malaria

 In areas with chloroquine resistant P. vivax, artemisinin-based combination therapies
(particularly those whose partner medicines have long half-lives) are recommended for the
treatment of P. vivax malaria.
Weak recommendation, moderate quality evidence.

 At least a 14-day course of primaquine is required for the radical treatment of P. vivax.
Strong recommendation, very low quality evidence.

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