Malaria can be a severe, potentially fatal disease (especially when caused by Plasmodium falciparum) and treatment should be initiated as soon as possible.
Patients who have severe P. falciparum malaria or who cannot take oral medications should be given the treatment by continuous intravenous infusion.
Most drugs used in treatment are active against the parasite forms in the blood (the form that causes disease) and include:
- chloroquine
- atovaquone-proguanil (Malarone®)
- artemether-lumefantrine (Coartem®)
- mefloquine (Lariam®)
- quinine
- quinidine
- doxycycline (used in combination with quinine)
- clindamycin (used in combination with quinine)
- artesunate (not licensed for use in the United States, but available through the CDC malaria hotline)
In addition, primaquine is active against the dormant parasite liver forms (hypnozoites) and prevents relapses. Primaquine should not be taken by pregnant women or by people who are deficient in G6PD (glucose-6-phosphate dehydrogenase). Patients should not take primaquine until a screening test has excluded G6PD deficiency.
How to treat a patient with malaria depends on:
- The type (species) of the infecting parasite
- The area where the infection was acquired and its drug-resistance status
- The clinical status of the patient
- Any accompanying illness or condition
- Pregnancy
- Drug allergies, or other medications taken by the patient
If you have or suspect you have malaria, you should contact your doctor immediately.
Source: Centers for Disease Control (CDC)
if the patient has an allergy for anti-malarials including fansidar how we will treat that patient? second, for the last 12years i used microscopy for searching for malaria species in giemsa stain. this is microscopic method. now i saw reagent stripes for malaria diagnosis any way which is better staining and reagent stripe. thanks i am abdinoor from kenya
Fansidar is no longer recommended for treatment of malaria – if a patient is allergic to Coartem or other ACTs, they should be given Malarone (atovaquone-proguanil), mefloquine, or doxycycline plus quinine. Thank you for your comment regarding diagnosis – I agree that reagent strip technology, which are used in rapid diagnostic tests for malaria, are proving to be very useful and convenient for diagnosis. – Claire
I got malaria Mar-12, doctor given LARIAGO-DS course that time it went completely again i got malariya May-12, doctor given LUMERAY course that time it went completely again i got malariya July-12, this time Lariago injections given doctor 6 nos that time again its cured again i got malariya Sepe-12. Can you advice what i has to use to complete prevention. With in 6 months i got 4 times.
Regards,
Sudhakar
Hi Suhakar,
It sounds as if you’ve had a difficult 6 months. As the saying goes, the best treatment is PREVENTION. Please see http://malaria.com/overview/malaria-prevention-control for tips on how to protect yourself from malaria. And next time you feel sick, be sure your health provider tests your blood to see if you have malaria and to determine the type.
Hi Suhakar,
It sounds as if you’ve had a difficult 6 months. As the saying goes, the best treatment is PREVENTION. Please see http://malaria.com/overview/malaria-prevention-control for tips on how to protect yourself from malaria. And next time you feel sick, be sure your health provider tests your blood to see if you have malaria and to determine the type. That way the treatment can be tailored to the specific type of malaria you have.
I was born in Africa (GHANA) in 1950 because my father was working there at the time. Both my parents were British. I had malaria, according to my mother and my medical records, 4 times. We moved to England when I was 6 and I lived there until 6 years ago when I decided to retire here in Italy.
Over the more recent years about 2-4 times a year and its irrespective of the time of year, I get influenza or malaria symptoms. It usually starts with stomach ache and over a period of hours I develop Diarrhoea, hot and cold feelings, includings sweats. All my joints seem to ache. i develop a quite severe headache with the fever type symptoms I am very tired, feelvery weak and at the worst just want to lie in bed and I tend to drift in and out of sleep. It can last from one to three days.
I usually get through it by taking aspirin or paracetomol and usually start to feel better as the diarrhoea and stomach pains subside.
Because they are flu type symptoms that’s what I’ve thought it was.
I have had boughts here in Italy in the summer and had a problem last week when on holiday in Tunisia. Also some years ago when on holiday in Turkey.
Is it possible it is the malaria comng back and if so can I get tested to check for it and therefore get treatment to get rid of it permanently?
When I have the problem I feel so lousy I go to bed rather than the doctors and by the time I feel well enough to go to the doctors the symptoms have either subsided or gone.
Thanking you in anticipation of your help.
Nigel Fox
There can be a recurrence of some forms of malaria and it is best to rule out that possibility by having a blood test for malaria the next time you get such an attack. If you do have malaria, it can be treated.
Need suggestion on how to ensure elimination of Malaria from my body which is a rare sort of case of Malaria. The details are as mentioned below and thanking you in anticipation:
1994:- Bout of very severe chill and cold. spleen enlarged by high extent. doctor initiated chloroquine (lariago tablets) and requested tests for Malaria, Typhoid and Kalazaar (Black Fever). Test came positive for typhoid, negative for Malaria. So Malaria medicine stopped just after 1 day. Fever used to be very high – upto 104.
1995:- Similar high fever happened 4-5 times with spleen enlarged – but always without cold, chill. Always – Typhoid came positive – doctors treated with higher antibiotics everytime thinking typhoid is replacing even after completion of dosage.
1996:- All possible tests done on body to see why fever was coming back. all found OK. doctors refer me to the best hospital in India – AIIMS (All india Institute of Medical Sciences). First Heamatology department conducted 100s of test – everything found OK – so they referred me to Physician in AIIMs.
The head of Physician department said this is Chronic Malaria (though it still showed negative in tests) – treatment done with following dosage:- 2 tablets of chloroquine (lariago) once a week….and continued it for 1.5 years.
Fever stopped coming and next 10 years – no such fever happened.
2007:- Again high fever 102+ came, no chill,…now even typhoid was negative…..Reziz tablet given after hearing the history. Fever went away. Again came back in a month. This time, looking at history – earlier treatment give chloroquine (lariago) – double strength. Fever goes away.
2007:- I visited a very good hospital to check if recurrence can be stopped. doctor gives me Primaquine (but no chloroquine along with it).
2012: This year, in Mar – blood clots came in urine. doctor treats me with Urinary Tract Infection. 10 days after medicine for UTI is over, Fever comes back – with burning sensation in urine. Doctors treat me for relapse of UTI. After that, in last 6 months, 4 times fever came. Appeared like normal viral fever, but looking at frequency of it – I am very worried. Every test is OK – but fever keeps coming back. Last week – during fever, felt like not eating, but having fluids only. And a little bit of tiredness and weakness. After fever, for precaution I got a full body health check up done. Again – spleen is found a bit enlarged. I fear, again this is malaria and really dont have answer to some of the questions…….if you could please let me know:
1. How to ensure if its Malaria only?
2. How to ensure it does not relapse – should I go for ACT? If so – could you please suggest the exact medicine, dosage and other details?
3. could it be possible that blood clot in urine could have been due to Malaria? First time – it came without pain during urination. Later on – once medication for UTI started – there was a bit of pain when i stopped the medicines.
4. Are there any such known circumstances of similar recurrences and any known treatment which has worked in such cases.
My other personal details: Male, Age 34, Weight – 70kg, No known medical allergy
It is hard to give you advice without knowing more details – do you know if you were actually diagnosed with Plasmodium vivax? You say you were diagnosed with “chronic malaria”, but this actually means different things in different contexts. The course of primaquine should have killed all dormant forms of the malaria parasite in the liver, if indeed you were infected with P. vivax (or P. ovale, the other type of malaria to cause recurring symptoms). Recent data on certain cases where primaquine treatment has failed suggest that in these cases, a larger dose in necessary. Also, it sounds like you live in India – if so, even if your past dose of primaquine was successful, you are still possibly at risk of getting re-infected with malaria, in which case you should go to your doctor again for a blood test and diagnosis before seeking treatment. However, from your description of your most recent symptoms in March 2012, there is not strong evidence that you are suffering from malaria. There is a rare complication of malaria in which blood is found in the urine (this is known as black-water fever) but it would present as very dark urine overall, rather than clots; also, you would have had a very high fever BEFORE the blood in urine, and any blood test for malaria would almost definitely have come back positive, as to experience severe symptoms, you generally have a high density of malaria parasites in the blood, making diagnosis very straightforward. All in all, if you still experience recurring fevers, together with chills and body aches, I would suggest having a blood test to look for malaria.