علاج الملاريا مع الطفيليات اللاجنسية وميزة شدة واحدة أو أكثر

References

• Severe falciparum malaria: For epidemiological purposes, severe falciparum malaria is defined as one or more of the following, occurring in the absence of an identified alternative cause and in the presence of P. falciparum asexual parasitaemia.
• Impaired consciousness: A Glasgow coma score < 11 in adults or a Blantyre coma score < 3 in children.
• Multiple convulsions: More than two episodes within 24 h.
• Hypoglycaemia: Blood or plasma glucose < 2.2 mmol/L (< 40 mg/dL).
• Hyperparasitaemia: P. falciparum parasitaemia > 10%.
• Adults and children with severe malaria (including infants, pregnant women in all trimesters and lactating women) should be treated with intravenous or intramuscular artesunate for at least 24 h and until they can tolerate oral medication.
• Once a patient has received at least 24 h of parenteral therapy and can tolerate oral therapy, treatment should be completed with 3 days of an ACT.
• Children weighing < 20 kg should receive a higher dose of artesunate (3 mg/kg bw per dose) than larger children and adults (2.4 mg/kg bw per dose) to ensure equivalent exposure to the drug.
• After initial parenteral treatment, once the patient can tolerate oral therapy, it is essential to continue and complete treatment with an effective oral antimalarial drug by giving a full course of effective ACT (artesunate + amodiaquine, artemether + lumefantrine or dihydroartemisinin + piperaquine).