treatment

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Non-falciparum malaria

  • Malaria caused by P. ovale, P. vivax and P. malariae can be treated in an/on outpatient basis (except in instances where the patient has other co-morbidities)
  • Haemoglobin concentration should be measured
  • glucose-6-phosphate dehydrogenase (G6PD) activity should be measured in patients with vivax or ovale since primaquinine therapy is needed to eliminate hypnozoites (dormant forms) from the liver
  • patients with mixed infection (which includes falciparum parasites) and with an infection that cannot be speciated treatment should follow falciparum management

Falciparum malaria

  • all patients with falciparum malaria infections should initially be admitted to the hospital
  • due to the possibility of rapid progression and poor tolerance of oral therapies children also should be admitted to the hospital for at least 24 hours
  • pregnant women, infants and the elderly should be monitored closely since they have an increased risk of developing severe disease or to deteriorate rapidly
  • specialist advice should be sought in management of severe falciparum malaria (1)

Treatment alternatives are dependent on whether the patient has a severe (complicated) infection (with P. falciparum or other species), or the patient has an uncomplicated mild infection.

Reference:

Last reviewed 03/2019

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