Treatment of recurrent Malaria

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QUESTION

If one takes the first dose of Coartem and tests indicate presence of malaria parasites,is it advisable to take a second round of coartem, or to start on quinine? Is quinine usually administered on its own or in conjunction with another drug? At what point is malaria considered complicated?

ANSWER

Usually, if a first round of treatment is unsuccessful, a doctor will prescribe a different type of oral medication for another attempt, such as atovaquone-proguanil or doxycycline in combination with another anti-malarial.

Quinine, when administered orally, can be given alone but is more commonly given with another anti-malarial compound such as doxycycline, tetracycline or clindamycin.

In cases of complicated malaria, it is administered intravenously. There are a number of symptoms which, in combination with a history of high fever, define complicated/severe malaria, among which are:

  • Prostration (inability to sit), altered consciousness lethargy or coma
  • Breathing difficulties
  • Severe anaemia
  • Generalized convulsions/fits
  • Inability to drink/vomiting
  • Dark and/or limited production of urine

In addition, intravenous quinine may be given to patients who are unable to take oral medication for whatever reason.

Duration of Malaria Fever for Child

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QUESTION

Can fever duration in malaria is 5-6 Hours for back?

And if I m giving 5 ML of Lariago to my 5 Yr Child how many days it will take to reduce the fever or increase the gap of fever coming back in 5-6 hours.

ANSWER

Please give more information regarding the first part of your question – I am not sure what you are asking regarding malaria fever duration? Regarding Lariago, its active ingredient is chloroquine phosphate, which is NOT effective against malaria in many places, due to widespread resistance. This is particularly true of Plasmodium falciparum, the most deadly kind of malaria. A blood smear can determine the species identification of malaria. As such it is important to know whether malaria in your area is known to have resistance to chloroquine prior to using chloroquine derivatives such as Lariago. Regardless, the World Health Organization now recommends artemisinin-based combination therapies (ACTs) as first line treatment for all non-complicated malaria. If a patient is suffering from complicated/severe malaria, or is unable to ingest malaria medication, they will require hospitalization, and likely be treated with intravenous quinine or artemisinin-derivative suppository, depending on their age and condition.

Treatment of Malaria

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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.

Curing Malaria

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QUESTION

What is needed to cure malaria?

ANSWER

Malaria is usually cured through treatment with an anti-malarial drug. The World Health Organization recommends use of an ACT (artemisinin-based combination therapy, such as Coartem) as first-line treatment for all non-complicated (i.e. not severe) malaria, and especially P. falciparum malaria (which in most places is resistance to chloroquine, and also to mefloquine in some locations). For complicated, severe malaria, or in cases where the patient is unable to take medication orally, the recommended treatment is intravenous quinine.

How is Malaria Treated

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QUESTION

How is malaria treated today?

ANSWER

Several different medications exist which are used for the treatment of malaria. The exact drug and method of treatment depends somewhat on the type of malaria the patient is infected with.

In most cases of non-complicated (i.e. when the patient is stable and conscious) malaria, the World Health Organisation recommends an orally-administered (in the form of solid pills) artemisinin-based combination therapy (ACT), such as Coartem (a combination of artemether and lumefantrine). Other types of medication include atovaquone-proguanil (Malarone) and sulfadoxine-pyrimethamine (Fansidar). In some locations, where chloroquine-resistance is not a problem, chloroquine can also be used as a treatment. For complicated malaria, where the patient is in a more severe state, intravenously administered quinine is usually the first-line treatment.

If diagnosed early and the patient is given appropriate medication, virtually all cases of uncomplicated malaria can be effectively treated.

Cure for Malaria

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QUESTION

Is there a cure for Malaria?

ANSWER

Yes. Several different medications exist which are used for the treatment of malaria. The exact drug and method of treatment depends somewhat on the type of malaria the patient is infected with. In most cases of non-complicated (i.e. when the patient is stable and conscious) malaria, the World Health Organisation recommends an orally-administered (in the form of solid pills) artemisinin-based combination therapy (ACT), such as Coartem (a combination of artemether and lumefantrine). Other types of medication include atovaquone-proguanil (Malarone) and sulfadoxine-pyrimethamine (Fansidar). In some locations, where chloroquine-resistance is not a problem, chloroquine can also be used as a treatment. For complicated malaria, where the patient is in a more severe state, intravenously administered quinine is usually the first-line treatment.

If diagnosed early and the patient is given appropriate medication, virtually all cases of uncomplicated malaria can be effectively treated.