Page 5 - 80 guidelines for the treatment of malaria_opt

Contents

Glossary v
Abbreviations viii

Executive summary ix

1. Introduction 1
1.1 Background 1
1.2 Objectives and target audience 1
1.3 Methods used in developing the guidelines and recommendations 2

2. Clinical disease and epidemiology 4
3. Objectives of treatment 6
3.1 Uncomplicated malaria 6
3.2 Severe malaria 6

4. Resistance to antimalarial medicines 6
4.1 Impact of resistance 7
4.2 Global distribution of resistance 7
4.3 Assessing efficacy and resistance 7
5. Antimalarial treatment policy 8
5.1 Criteria for antimalarial treatment policy change 8
5.2 Therapeutic efficacy cut-offs for changing treatment policy 8

6. Diagnosis of malaria 9
6.1 Clinical diagnosis 9
6.2 Parasitological diagnosis 10
6.3 Where malaria transmission is low-to-moderate and/or unstable 11
6.4 In stable high-transmission settings 12
6.5 Malaria parasite species identification 12
6.6 In epidemics and complex emergencies 12
7. Treatment of uncomplicated P. falciparum malaria 13
7.1 Definition of uncomplicated malaria 13
7.2 Rationale for antimalarial combination therapy 13
7.3 ACT options 15
7.4 Management of treatment failures 17
7.5 Practical aspects of treatment with recommended ACTs 19
7.6 Incorrect approaches to treatment 21
7.7 Additional considerations for clinical management 22
7.8 Operational issues in treatment management 23
7.9 Treatment in specific populations and situations 26
7.10 Co-existing morbidities 32

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