Treatment of uncomplicated falciparum malaria in nonpregnant adults and children
- Johanna Daily, MD, MSc
Johanna Daily, MD, MSc
- Section Editor — Malaria
- Associate Professor, Department of Medicine, Division of Infectious Diseases
- Albert Einstein College of Medicine
- Section Editors
- Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
- Section Editor — Travel Medicine
- Head of Infectious Diseases Unit
- Monash University, Australia
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
Uncomplicated falciparum malaria consists of symptomatic Plasmodium falciparum infection with a positive parasitologic test and parasitemia <4 percent, in the absence of symptoms consistent with severe malaria (table 1).
Issues related to treatment of uncomplicated falciparum malaria in nonpregnant adults and children will be reviewed here. Issues related to treatment of severe malaria, treatment of malaria in pregnant women, and treatment of non-falciparum malaria are discussed separately. (See "Treatment of severe malaria" and "Prevention and treatment of malaria in pregnant women" and "Overview of non-falciparum malaria in nonpregnant adults and children".)
Uncomplicated falciparum malaria consists of symptomatic P. falciparum infection with a positive parasitologic test and parasitemia <4 percent, in the absence of symptoms consistent with severe malaria (table 1). (See "Treatment of severe malaria".)
To establish the diagnosis of malaria, microscopy of blood smears or a rapid diagnostic test (RDT) should be performed. RDTs often can provide the speciation to guide therapy. If the initial diagnostic evaluation is negative, follow-up testing should be performed each day for two more days. (See "Diagnosis of malaria".)
PRINCIPLES OF TREATMENT
Issues related to treatment of malaria, including indications for hospitalization, antimalarial selection and parasitemia monitoring are discussed below.
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- PRINCIPLES OF TREATMENT
- Indications for hospitalization
- Antimalarial selection
- - Chloroquine-sensitive malaria
- Clinical approach
- Reversion of chloroquine resistance
- - Chloroquine-resistant malaria
- Within endemic areas
- - Clinical approach
- - Recurrent infection
- - Reducing transmissibility
- - Artemisinin resistance
- Outside endemic areas
- - Clinical approach
- - Recrudescence
- Monitoring parasitemia
- INVESTIGATIONAL ANTIMALARIAL DRUGS
- SUMMARY AND RECOMMENDATIONS