Treatment of Uncomplicated P. vivax, P. ovale, P. malariae or P. knowlesi Malaria in Chloroquine-Resistant Areas
When uncomplicated malaria due to P. vivax, P. ovale, P. malariae, or P. knowlesi occurs in an area where chloroquine-resistant infections are documented, standard chloroquine therapy is not adequate. A different treatment strategy is required for both adults and children in this setting.
Uncomplicated P. vivax, P. ovale, P. malariae, or P. knowlesi malaria in a geographic area with chloroquine-resistant infections — applicable to adults and children.
Management involves an artemisinin-based combination therapy (ACT). Several ACT options exist, with the appropriate choice depending on local epidemiology and drug availability. The complete regimen, agent selection, and full clinical algorithm are available in the structured protocol below.
Rates of recurrent parasitaemia of any origin below 10% within 28 days.
References
- In areas with chloroquine-resistant infections, adults and children with uncomplicated P. vivax, P. ovale, P. malariae or P. knowlesi malaria should be treated with an ACT.
- ACTs containing piperaquine, mefloquine or lumefantrine are the recommended treatment, although artesunate + amodiaquine may also be effective in some areas.
- Current methods do not distinguish recrudescence from relapse or relapse from newly acquired infection, but the aim of treatment is to ensure that the rates of recurrent parasitaemia of any origin is < 10% within 28 days.