Treatment and prevention of plasmodium falciparum malaria

ABSTRACT

Malaria remains the most prevalent and devastating public health problem in Africa despite considerable research and control efforts over the last two decades. Chloroquine in total dose of 25mg/Kg over three days is the first choice treatment of malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25mg/Kg over three days is the second line treatment. Pyrimethamine/sulphonamide combinations are useful in areas where resistance to 4-aminoquinolines exist. Quinine 10mg/Kg every eight hours for seven days is the treatment of choice for severe and complicated malaria. In most parts of Africa; Proguanil 200mg daily together with chloroquine 5 mg/Kg per week is recommended for prophylaxis. However; in hard core multi-drug resistance areas; mefloquine 250mg once weekly together with chloroquine 300mg weekly is recommended. Because no anti-malarial drug can guarantee absolute protection against infection; basic preventive measures like the use of mosquito nets impregnated with permethrin; insecticides and mosquito repellents are advocated for those at high risk of severe malaria