Guidelines for Diagnosis & Treatment of Malaria in India ... - NVBDCP
Guidelines for Diagnosis & Treatment of Malaria in India ... - NVBDCP
Guidelines for Diagnosis & Treatment of Malaria in India ... - NVBDCP
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<strong>Guidel<strong>in</strong>es</strong> <strong>for</strong> diagnosis and treatment <strong>of</strong> malaria• Other chloroqu<strong>in</strong>e resistant PHCs and clusters <strong>of</strong> blockssurround<strong>in</strong>g identified drug resistant foci (see annexure).Individual cases who qualify <strong>for</strong> ACT• Patients with history <strong>of</strong> travel to listed areas.• No cl<strong>in</strong>ical or parasitological response to full dose <strong>of</strong> chloroqu<strong>in</strong>ewith<strong>in</strong> 72 hours <strong>of</strong> start<strong>in</strong>g the therapy.4.2.4 Can ACTs be given <strong>in</strong> pregnancy?Accord<strong>in</strong>g to current WHO guidel<strong>in</strong>es, ACTs can be given <strong>in</strong>the second and third trimester <strong>of</strong> pregnancy. The recommendedtreatment <strong>in</strong> the first trimester <strong>of</strong> pregnancy is qu<strong>in</strong><strong>in</strong>e.4.3 <strong>Treatment</strong> <strong>of</strong> mixed <strong>in</strong>fectionsMixed <strong>in</strong>fections with P. falciparum should be treated asfalciparum malaria.4.4 <strong>Treatment</strong> based on cl<strong>in</strong>ical criteria withoutlaboratory confirmationAll ef<strong>for</strong>ts should be made to diagnose malaria either bymicroscopy or RDT. However, special circumstances should beaddressed as mentioned below.What is the treatment, if RDT is negative and a microscopyresult cannot be obta<strong>in</strong>ed with<strong>in</strong> 24 hours?If RDT <strong>for</strong> only P. falciparum is used, negative cases show<strong>in</strong>gsigns and symptoms <strong>of</strong> malaria without any other obvious cause<strong>for</strong> fever should be considered as ‘cl<strong>in</strong>ical malaria’ and treatedwith chloroqu<strong>in</strong>e <strong>in</strong> full therapeutic dose <strong>of</strong> 25 mg/kg body weightover three days. If a slide result is obta<strong>in</strong>ed later, the treatmentshould be adjusted accord<strong>in</strong>g to species.What is the treatment, if neither RDK nor microscopy isavailable?‘Cl<strong>in</strong>ical malaria’ cases should be treated with chloroqu<strong>in</strong>e <strong>in</strong>full therapeutic dose.5