Treatment of choice for chloroquine resistant malaria is :
Ans. is 'b'. Sulfadoxine + Pyrimethamine * Under the recent 'National anti-Malaria Programme.' the drug policy for malaria treatment is as follows-Any fever in endemic areas during transmission season without any other obvious cause may be considered as malaria and investigated/treated accordingly.Drug resistance foci are prevalent in the country but chloroquine is still the safe, effective and cheap antimalarial drug and is simple to be administered.The best approach in malaria treatment is diagnosis and treatment on the same day.b(Plasmodium falciparum predominant and drug resistance areas)Presumptive treatment of all suspected/clinical malaria cases :Day 1 Tab. Chloroquine - 10 mg/kg body weight (600 mg adult dose)+Tab. Primaquine - 0.75 mg/kg body weight (45 mg adult dose)Day 2 Tab. Chloroquine - 10 mg/kg body weight (600 mg adult dose)Day 3 Tab. Chloroquine - 5 mg/kg body weight (300 mg adult dose)Radical treatment after microscopic confirmation of species :P vivax - Tab. Primaquine 0.25 mg/kg body wt. (15 mg adult does) daily for 5 days.P. falciparum - No further treatment required.In chloroquine resistant p. falciparum cases/areaSingle dose of 25 mg / kg bw tab. Sulfalene / Sulfadoxine and 1.25 gg/ kg body wt. Pyrimethamine combination (3 tabs, adult does) thereafter tab. Primaquine 0.75 mg/kg body wt. These drugs should be given cautiously and not on the same day as both are known to precipitate haemolytic crisis in sensitive cases with G6PD deficiency.In low risk areasPresumptive treatmentDay 1 - Tab. Chloroquine 10mg / kg body weight (600 mg adult does)Radical Treatment after confirmation of speciesP. Vivax - Tab. Chloroquine 10 mg/ kg body wt. single dose and tab. Primaquine 0.25 mg/kg body wt. daily for 5 days.R falciparum - Tab. Chloroquine 10 mg/ kg body wt. plus tab. Primaquine 0.75 mg / kg body wt. single dose.Severe and Complicated malaria - cases are to be hospitalized for treatment.Choice of antimalarial is quinine injection preferably, 10 mg/ kg body wt. I/V drip in5% dextrose saline to be run over 4 hours, 8 hourly. Switch over to oral dose as early as possible and total duration of treatment should be 7 days including both parenteral and oral doses.Injectable form of Artemisinin derivative may be used for severe and complicated malaria only. The recommended injectable dosages are as follows :Artemisinin - 10mg./kg body wt. once a day for 5 days with a double divided does on first day.Artesunate - 1 mg/kg body wt. IM or IV two doses at an internal of 4-6 hours on the first day followed by once a day for 5 daysArtemether - 1.6 mg/kg body wt. IM, two doses at an interval of 4-6 hours on the first day followed by once daily for 5 days.Artether - 150 mg daily IM for 3 days for adults onlyTab. Mefloquine is to be used only in Pf. cases having proven resistance to chloroquine.Primaquine is not to be given to pregnant women*, infants* and glucose 6 phosphatase deficient persons*.
Mefloquine
Sulfadoxine + Pyrimethamine
Primaquine + Chloroquine
Chloroquine + Pyrimethamine
Communicable Diseases