Mosquito-borne Diseases April 21, 2018

What Is The Treatment For Malaria?

The treatment of malaria depends on the species of malaria, as well as on the severity of the disease. All fever cases diagnosed as malaria by either RDT or microscopy should be promptly given effective treatment.

Treatment of P. vivax malaria:

 Confirmed P. vivax cases should be treated with chloroquine in full therapeutic dose of 25 mg/kg as per the age-wise dosage schedule given in Table 1. In some patients (ranging 8 to 30%) P. vivax may cause relapse (A form of P. vivax or P. ovale parasites known as hypnozoites which remain dormant in the liver cells can later cause a relapse). For its prevention, primaquine should be given at a dose of 0.25 mg/kg body weight daily for 14 days under supervision. The age-wise dosage schedule of primaquine is mentioned here.

Caution should be exercised before administering primaquine in areas known to have high prevalence of G6PD deficiency. Patient should be advised to stop primaquine immediately if he/she develops any of the following symptoms and should report to the doctor immediately: (i) dark coloured urine

 (ii) yellow conjunctiva

(iii) bluish discolouration of lips

(iv) abdominal pain

(v) nausea

 (vi) vomiting

(vii) breathlessness, etc.

Treatment of P. falciparum malaria:

Artemisinin Combination Therapy (ACT) should be given to all the confirmed P. falciparum cases found positive by microscopy or RDT. This is to be accompanied by single dose of primaquine (0.75 mg/kg body weight) on Day 2. ACT consists of an artemisinin derivative combined with a longacting antimalarial (amodiaquine, lumefantrine, mefloquine, piperaquine or sulfadoxine-pyrimethamine). The ACT recommended in the National Programme all over India except northeastern states is artesunate (4 mg/kg body weight) daily for 3 days and sulfadoxine (25 mg/kg body weight) -pyrimethamine (1.25 mg/kg body weight) [AS+SP] on Day 0.

Treatment of malaria in pregnancy:

The ACT should be given for treatment of P. falciparum malaria in second and third trimesters of pregnancy, while quinine is recommended in the first trimester. Plasmodium vivax malaria can be treated with chloroquine.

Treatment of mixed infections:

Mixed infections with P. falciparum should be treated as falciparum malaria. Since AS+SP is not effective in vivax malaria, other ACT should be used. However, anti-relapse treatment with primaquine can be given for 14 days, if indicated.

General recommendations for the management of uncomplicated malaria:

1. Avoid starting treatment on an empty stomach. The first dose should be given under observation.
2. Dose should be repeated if vomiting occurs within half an hour of antimalarial intake.
3. The patient should be asked to report back, if there is no improvement after 48 hours or if the situation deteriorates.
4. The patient should also be examined and investigated for concomitant illnesses.

Avoiding Malaria:

The easiest and the most effective way to save yourself from this disease is by using mosquito repellents regularly. Using indoor mosquito repellers like Goodknight Gold Flash and outdoor repellents like Goodknight Fabric Roll-On can protect you from the disease-causing mosquitoes. The 2x power of the Goodknight Gold Flash can provide complete protection against the mosquitoes. Just 4 dots of the Goodknight Fabric Roll-On on clothes provides 8 hours of mosquito-protection. It is made using 100% natural ingredients such as citronella and eucalyptus oils.