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Guidelines for the treatment of malaria – 2 edition

8. Treatment of severe P. falciparum malaria 35
8.1 Definition 35
8.2 Treatment objectives 36
8.3 Clinical assessment 36
8.4 Specific antimalarial treatment 37
8.5 Follow-on treatment 39
8.6 Pre-referral treatment options 39
8.7 Practical aspects of treatment 42
8.8 Adjunctive treatment 43
8.9 Continuing supportive care 44
8.10 Additional aspects of management 45
8.11 Treatment of severe malaria in special groups during pregnancy 47

9. Treatment of malaria caused by P. vivax, P. ovale or P. malariae 47
9.1 Diagnosis 48
9.2 Susceptibility of P. vivax, P. ovale and P. malariae to antimalarials 48
9.3 Treatment of uncomplicated vivax malaria 49
9.4 Treatment of severe P. vivax malaria 52
9.5 Treatment of malaria caused by P. ovale and P. malariae 53
9.6 Monitoring therapeutic efficacy for vivax malaria 53
10. Mixed malaria infections 54

11. Complex emergencies and epidemics 54
11.1 Diagnosis 54
11.2 Management of uncomplicated falciparum malaria 55
11.3 Areas prone to mixed falciparum/vivax malaria epidemics 56
11.4 Areas prone to vivax malaria epidemics 56
11.5 Anti-relapse therapy in vivax malaria epidemics 56
11.6 Management of severe falciparum malaria 56

12. Case management in the context of malaria elimination 58
12.1 Use of gametocytocidal drugs to reduce transmission 58
12.2 Mass screening and treatment 58
13. Mass drug administration 59

Annexes 61
Annex 1. The guidelines development process 63
Annex 2. Adaptation of the WHO malaria treatment guidelines for use in countries 71
Annex 3. Pharmacology of antimalarial medicines 73
Annex 4. Antimalarials and malaria transmission 109
Annex 5. Malaria diagnosis 117
Annex 6. Resistance to antimalarial medicines 122
Annex 7. Uncomplicated P. falciparum malaria 134
Annex 8. Treatment of severe P. falciparum malaria 154
Annex 9. Treatment of P. vivax, P. ovale and P. malariae infections 166

Index 188
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