Guidelines for Diagnosis & Treatment of Malaria in India ... - NVBDCP

Guidelines for diagnosis and treatment of malariaRDTs are produced by different companies, so there may bedifferences in the contents and in the manner in which the test isdone. The user’s manual should always be read properly andinstructions followed meticulously. The results should be read atthe specified time. It is the responsibility of the clinician ortechnician doing a rapid test for malaria to ensure that the kit iswithin its expiry date and has been transported and stored underrecommended conditions. Failure to observe these criteria canlead to false/negative results. It should be noted that Pf HRP 2based kits may show positive result up to three weeks of successfultreatment.Early diagnosis and treatment of cases of malariaaims at:• Complete cure• Prevention of progression of uncomplicated malaria tosevere disease• Prevention of deaths• Interruption of transmission• Minimizing risk of selection and spread of drug resistantparasites.4. Treatment of uncomplicated malariaAll fever cases diagnosed as malaria by RDT or microscopyshould promptly be given effective treatment.4.1 Treatment of P. vivax casesPositive P. vivax cases should be treated with chloroquine infull therapeutic dose of 25 mg/kg divided over three days. Vivaxmalaria relapses due to the presence of hypnozoites in the liver.The relapse rate in vivax malaria in India is around 30%. For itsprevention, primaquine may be given at a dose of 0.25 mg/kgdaily for 14 days under supervision. Primaquine is contraindicatedin G6PD deficient patients, infants and pregnant women. Cautionshould be exercised before administering primaquine in areas3