Malaria

Non-Falciparum Management 1

P. vivax has also become resistant to chloroquine based therapies in many places.

Severe features are rare, the majority of patients can be treated with oral agents.

• Chloroquine if sensitive
• Artemether / Lumefantrine (Riamet) if resistant

Patients with P. vivax infection should also be given oral primaquine to eliminate dormant hypnozoites.

• Check G6PD levels first, as primaquine can cause massive haemolysis in G6PD deficiency

Resistance to chloroquine is not as common in P. Ovale.

• Severe features are also quite rare and therefore oral chloroquine treatment with added primaquine is sufficient

P. malariae is also not commonly found to be resistant to chloroquine and can be treated with oral chloroquine monotherapy.

P. knowlesi can cause severe malaria due to rapid increases in parasitaemia. In these cases, IV artesunate should be used however uncomplicated disease can be treated with oral medications.