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• Haemoglob<strong>in</strong>uria• Hyperthermia (Temperature >104 o F)• Hyperparasitaemia (>5% parasitized RBCs <strong>in</strong> low endemic and>10% <strong>in</strong> hyperendemic areas)Foetal and maternal complications are more common <strong>in</strong>pregnancy with severe malaria; there<strong>for</strong>e, they need promptattention.5.2 Can cases <strong>of</strong> severe malaria be negative onmicroscopy?Microscopic evidence may be negative <strong>for</strong> asexual parasites<strong>in</strong> patients with severe <strong>in</strong>fections due to sequestration and partialtreatment. Ef<strong>for</strong>ts should be made to confirm these cases by RDTor repeat microscopy. However, if the symptoms clearly po<strong>in</strong>t tosevere malaria and there is no alternative explanation, such acase should be treated accord<strong>in</strong>gly.5.3 Requirements <strong>for</strong> management <strong>of</strong> complicationsFor management <strong>of</strong> severe malaria, health facilities shouldbe equipped with the follow<strong>in</strong>g:• Parenteral antimalarials, antibiotics, anticonvulsants,antipyretics• Intravenous <strong>in</strong>fusion equipment and fluids• Special nurs<strong>in</strong>g <strong>for</strong> patients <strong>in</strong> coma• Blood transfusion• Well-equipped laboratory• OxygenIf these items are not available, the patient must be referred withoutdelay to a facility, where they are available.5.4 Specific antimalarial treatment <strong>of</strong> severe malariaSevere malaria is an emergency and treatment should begiven promptly.9