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> malariaRDTs are produced by different companies, so there may bedifferences <strong>in</strong> the contents and <strong>in</strong> the manner <strong>in</strong> which the test isdone. The user’s manual should always be read properly and<strong>in</strong>structions followed meticulously. The results should be read atthe specified time. It is the responsibility <strong>of</strong> the cl<strong>in</strong>ician ortechnician do<strong>in</strong>g a rapid test <strong>for</strong> malaria to ensure that the kit iswith<strong>in</strong> 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 <strong>of</strong> successfultreatment.Early diagnosis and treatment <strong>of</strong> cases <strong>of</strong> malariaaims at:• Complete cure• Prevention <strong>of</strong> progression <strong>of</strong> uncomplicated malaria tosevere disease• Prevention <strong>of</strong> deaths• Interruption <strong>of</strong> transmission• M<strong>in</strong>imiz<strong>in</strong>g risk <strong>of</strong> selection and spread <strong>of</strong> drug resistantparasites.4. <strong>Treatment</strong> <strong>of</strong> uncomplicated malariaAll fever cases diagnosed as malaria by RDT or microscopyshould promptly be given effective treatment.4.1 <strong>Treatment</strong> <strong>of</strong> P. vivax casesPositive P. vivax cases should be treated with chloroqu<strong>in</strong>e <strong>in</strong>full therapeutic dose <strong>of</strong> 25 mg/kg divided over three days. Vivaxmalaria relapses due to the presence <strong>of</strong> hypnozoites <strong>in</strong> the liver.The relapse rate <strong>in</strong> vivax malaria <strong>in</strong> <strong>India</strong> is around 30%. For itsprevention, primaqu<strong>in</strong>e may be given at a dose <strong>of</strong> 0.25 mg/kgdaily <strong>for</strong> 14 days under supervision. Primaqu<strong>in</strong>e is contra<strong>in</strong>dicated<strong>in</strong> G6PD deficient patients, <strong>in</strong>fants and pregnant women. Cautionshould be exercised be<strong>for</strong>e adm<strong>in</strong>ister<strong>in</strong>g primaqu<strong>in</strong>e <strong>in</strong> areas3