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• Intravenous preparations should be preferred over<strong>in</strong>tramuscular preparations• In first trimester <strong>of</strong> pregnancy, parenteral qu<strong>in</strong><strong>in</strong>e is the drug<strong>of</strong> choice. However, if qu<strong>in</strong><strong>in</strong>e is not available, artemis<strong>in</strong><strong>in</strong>derivatives may be given to save the life <strong>of</strong> mother. In secondand third trimester, parenteral artemis<strong>in</strong><strong>in</strong> derivatives arepreferred.5.5 Can P. vivax lead to severe malaria?In recent years, <strong>in</strong>creased attention has been drawn to severemalaria caused by P. vivax. Some cases have been reported <strong>in</strong><strong>India</strong>, and there is reason to fear that this problem will becomemore common <strong>in</strong> the com<strong>in</strong>g years. Severe malaria caused byP. vivax should be treated like severe P. falciparum malaria.6. ChemoprophylaxisChemoprophylaxis is recommended <strong>for</strong> travellers, migrantlabourers and military personnel exposed to malaria <strong>in</strong> highlyendemic areas. Use <strong>of</strong> personal protection measures like<strong>in</strong>secticide-treated bednets should be encouraged <strong>for</strong> pregnantwomen and other vulnerable populations.6.1 For short-term chemoprophylaxis (less than 6 weeks)Doxycycl<strong>in</strong>e: 100 mg daily <strong>in</strong> adults and 1.5 mg/kg <strong>for</strong> childrenmore than 8 years old. The drug should be started 2 days be<strong>for</strong>etravel and cont<strong>in</strong>ued <strong>for</strong> 4 weeks after leav<strong>in</strong>g the malarious area.Note: Doxycycl<strong>in</strong>e is contra<strong>in</strong>dicated <strong>in</strong> pregnant women andchildren less than 8 years.6.2 For long-term chemoprophylaxis (more than 6 weeks)Mefloqu<strong>in</strong>e: 5 mg/kg bw (up to 250 mg) weekly and should beadm<strong>in</strong>istered two weeks be<strong>for</strong>e, dur<strong>in</strong>g and four weeks afterleav<strong>in</strong>g the area.Note: Mefloqu<strong>in</strong>e is contra<strong>in</strong>dicated <strong>in</strong> cases with history <strong>of</strong>convulsions, neuropsychiatric problems and cardiac conditions.11