QUESTION:

What is the treatment for malaria in Africa?

ANSWER:

The appropriate form of treatment for malaria, regardless of where you are, depends on the type of malaria you have. This can be determined through diagnosis; each of the main malaria parasites that ordinarily infect humans (P. falciparum, P. vivax, P. malariae and P. ovale) looks slightly different under the microscope, although you have to be well trained to tell them apart! Rapid diagnostic tests (RDTs) can also sometimes distinguish between malaria species, although many RDTs only test for P. falciparum, he most acute, severe and deadly of the species.

In much of Africa, P. falciparum is the most common and dangerous form of the disease. In some places, it can be treated with chloroquine, though in many places the parasite has developed resistance to this drug, so other treatment is necessary.

The most common drugs given in areas with known chloroquine-resistant strains of P. falciparum are ACTs (artemisinin-based combined therapies). There are some parts of Africa where other forms of malaria, such as P. ovale and P. vivax, can also occur – it is important to know whether a patient is infected with these species as they require an additional form of treatment, the drug primequine, in order to kill dormant liver stages that characterise these species and can lead to a relapse of infection months or even years after the initial exposure.