How is Malaria Treated

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QUESTION

how is malaria treated?

ANSWER

Malaria can be a severe, potentially fatal disease (especially when caused by Plasmodium falciparum) and treatment should be initiated as soon as possible.

Patients who have severe P. falciparum malaria or who cannot take oral medications should be given the treatment by continuous intravenous infusion.

Most drugs used in treatment are active against the parasite forms in the blood (the form that causes disease) and include:

  • chloroquine
  • atovaquone-proguanil (Malarone®)
  • artemether-lumefantrine (Coartem®)
  • mefloquine (Lariam®)
  • quinine
  • quinidine
  • doxycycline (used in combination with quinine)
  • clindamycin (used in combination with quinine)
  • artesunate (not licensed for use in the United States, but available through the CDC malaria hotline)

In addition, primaquine is active against the dormant parasite liver forms (hypnozoites) and prevents relapses. Primaquine should not be taken by pregnant women or by people who are deficient in G6PD (glucose-6-phosphate dehydrogenase). Patients should not take primaquine until a screening test has excluded G6PD deficiency.

How to treat a patient with malaria depends on:

  • The type (species) of the infecting parasite
  • The area where the infection was acquired and its drug-resistance status
  • The clinical status of the patient
  • Any accompanying illness or condition
  • Pregnancy
  • Drug allergies, or other medications taken by the patient

If you have or suspect you have malaria, you should contact your doctor immediately.

Malaria in Haiti

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QUESTION

I just recently returned from Senegal, 60 days ago, in which I had taken Malaria medicine; Chloroquine. I am heading to Haiti in 5 days, and wondering if I am in need of taking Malaria medicine again, or was the time frame close enough that it would be fine to go without.

ANSWER

You are only protected against malaria while you are taking the anti-malarial prophylactic medicine. All of Haiti is considered at risk for malaria, and so you should talke anti-malarial medication throughout the duration of your stay, plus the required time afterwards (depending on which type of prophylactic medication you take). Chloroquine is considered suitable as an anti-malarial for Haiti, as is atovaquone-proguanil (Malarone), doxycycline and mefloquine (Lariam).