Treatment of Uncomplicated P. falciparum Malaria with a Positive Parasitological Test (Microscopy or RDT)

This protocol covers the management of patients presenting with symptoms of malaria who have a confirmed positive parasitological test — by microscopy or rapid diagnostic test (RDT) — and no features of severe malaria, in both children and adults.

Clinical scenario

A patient who presents with symptoms of malaria and a positive parasitological test (microscopy or RDT) but with no features of severe malaria is defined as having uncomplicated malaria. This definition applies regardless of age.

Treatment goals

Elimination of all parasites from the body, with resolution of fever and parasitaemia. Success requires no recurrence of fever or parasitaemia within 4 weeks (28 days) of treatment.

Treatment approach

Recommended treatment involves a complete course of an artemisinin-based combination therapy (ACT). Multiple ACT options exist — the full protocol specifies which regimens are recommended and guides selection for this scenario.

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References

Children and adults with uncomplicated P. falciparum malaria should be treated with one of the following ACTs*:

ACT regimens should provide 3 days' treatment with an artemisinin derivative.

“Cure” is defined as elimination of all parasites from the body.

In individual patients, it may not be possible to distinguish recrudescence from re-infection, although lack of resolution of fever and parasitaemia or their recurrence within 4 weeks of treatment are considered failures of treatment with currently recommended ACTs.

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