1. Uncomplicated Malaria presumptive (UMP):

Definition:

•  Fever or history of fever over the last 48 hours
•  Absence of definite features of any other febrile illness
•  Living in or traveling to Endemic area(s)
•  PBF or Rapid DiagnosticTest (RDT) is not available

Treatment:

2. Uncomplicated Malaria confirmed (UMC):

Definition:

•  Fever or history of fever over the last 48 hours
• Absence of definite features of any other febrile illness
•  Living in or traveling to Endemic area(s)
•  Diagnosis is confirmed by PBF or Rapid diagnostic test (RDT).

Treatment:

For P. vivax infection (Also for Chloroquine sensitive malaria):

Then, Tab. Primaquine (15 mg base) – 1 tab daily for more 14 days.

OR,
1 st day – Tab. Chloroquine (150 mg base) – 4 tab at a time and after 6-8 hrs
Tab. Chloroquine (150 mg base) – 2 tab at a time
2 nd day – Tab. Chloroquine (150 mg base) – 2 tab at a time – 24 hrs after last intake
3 rd day – Tab. Chloroquine (150 mg base) – 2 tab at a time – 24 hrs after last intake
From 4 th day – Tab. Primaquine (15 mg base) – 1 tab / day – for 14 – 21 days.

For P. falciparum infection (Also for Chloroquine resistant malaria):

1st line treatment:

Tab. Coartem (Artemethur 20mg + Lumefantrine 120mg) – 24 tablets in 6 divided dosages for adults (in 3 days) i.e. 4 tab 2 times daily for 3 days where on the 1 st day – 4 tab should be taken stat & another 4 tab after 12 hours.

2nd line treatment:

3. Severe Malaria:

Definition:

Severe malaria includes-

1. Fever or history of fever over the last 48 hours
2. Presence of asexual form of P. falciparum in PBF or positive RDT
3. Presence of one or more of the following features of severity:

• Confusion
• Abnormal behavior
• Convulsion
• Hypoglycemia
• Inability to stand or walk
• Moderate to severe vomiting
• Severe diarrhea
• Acute renal failure
• Acute pulmonary edema
• Severe anemia
• Jaundice
• Bleeding due to DIC
• Shock
• Unconsciousness.

Treatment for severe malaria:

Quinine HCl – IV at a dose of 20 mg /kg with 500 ml 5 % DA or DNS over 4 hours (at a rate of 30 drops/min). It is repeated at a dose of 10 mg /kg at an interval of 8-12 hours until the patient become conscious. After regaining consciousness –

Tab. Quinine (300mg base) is given for 7 days.
OR,
Artemether – IV/IM at a dose of 3.2 mg /kg, followed by at a dose of 1.6 mg /kg -1 st day 12 hourly then once daily.
OR,
Arteseunate – IV/IM at a dose of 2.4 mg /kg, followed by at a dose of 1.2 mg /kg -1st day 12 hourly then once daily.

To know the Generic and Trade names of the above mentioned drugs and their available formulations in Bangladesh click here.