MALARIA TREATMENT PROTOCOL. Third edition June 2007. Ministry of Health Republic Democratic of Timor- Leste. UNCOMPLICATED MALARIA . Uncomplicated malaria definition: Fever and any of the following: Headache, Body and joint pains Feeling cold and sometimes shivering
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Ministry of Health
Republic Democratic of Timor- Leste
Fever and any of the following:
Consider other illnesses, such as:
Remember that the patient may be suffering
from more than one illness.
P. falciparum malaria
Table 1 : Dosage and administration Coartem (Artemether 20 mg/Lumefantrine 120 mg) for uncomplicated malaria falciparum
Source: Guideline for the treatment of malaria, WHO; 2006
Source: WHO, 2007
1. It is obligatory to give Coartem® to patient whose dipstick test or blood slide is positive for P. falciparum and to the patient who has mixed infections P. falciparum and P .vivax.
2. Give the correct dosage of Coartem® from the appropriate blister according to the patient’s weight or age.
3. Children under 5 kg or below 4 months should not be given Coartem instead treat with the following regimen (see table 2).
Source: Malaria in Children, Department of tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University.
referring patient in other health facility coartem® could be administered. (The health facility manager should write explanatory note why giving coartem® without
6. Watch all patients swallowing the first dose of coartem® and observe for 1 hour after the intake. In the event of vomiting within one hour of administration, a repeat dose should be taken.
7. Inform patient that, the coartem® tablets are in the blister and after breaking should be taken immediately, as after 24 hours coartem® tablets exposed to air totally inactivated and can not be used for treatment of malaria.
8.Each blister of coartem® has expiry date and should not be used after the expiry date.
9. For small children, paracetamol and coartem® can be crushed, diluted in water and then put either directly into the mouth using a syringe or given with a spoon.
10. Any patient who seeks re-treatment for malaria within 2 weeks of taking full dose of any other antimalarial should be treated with coartem®.
P. vivax malaria
The type of malaria where both infections
occurs in patient requires treatment by
Negative dipstick or thin-thick blood smear:
For pregnant or lactated woman or child less than 8 years:
Severe or complicated malaria definition:
Fever and any of the following:
The congenital malaria is also treated with Artesunate, where 2.4 mg/kg is initially given through IV, followed by 1.2 mg/kg at 12 and 24 hr then every 24 hr for 3 -5 days.
Similarly in children including congenital malaria, it is infused over a period of two hours and repeated every eight hours (calculated from the beginning of the previous infusion) until the patient can swallow. To complete the seven-day to eight-day treatment in children, give Quinine sulfate 10 mg/kg per oral three times in a day. Increase the dosage of Quinine sulfate to 15-20 mg/kg after 4 days or add tetracycline 5 mg/kg twice a day for children above 7 years.