Diagnosis and Treatment
of
Malaria
2013
Dte. of National Vector Borne Disease Control Programme (NVBDCP) | Page-1
, Diagnosis and Treatment of Malaria in India
For malaria control, the main thrust of the National Vector Borne Diseases Control
programme (NVBDCP) is on early diagnosis and prompt, complete and effective treatment.
Malaria diagnosis is carried out by microscopic examination of blood films collected by
active and passive agencies. Health agencies and volunteers treating fever cases in
inaccessible areas are being provided with Rapid Diagnostic Test (RDT) kits (Pf specific so
far and now Bivalent RDT) for diagnosis of Malaria cases so as to provide full radical
treatment to the confirmed cases. It is stressed that all fever cases should be suspected of
malaria after ruling out other common causes and should be investigated for confirmation of
malaria by Microscopy or Rapid Diagnostic Kit (RDK) so as to ensure treatment with full
therapeutic dose with appropriate drug to all confirmed cases. Presumptive treatment of
malaria with a single dose of chloroquine has been stopped. In all cases of suspected
malaria which cannot be immediately confirmed by tests, full treatment with chloroquine for
3 days should be given. The malaria case management is very important for preventive
serious cases and death due to malaria. So, the private healthcare providers should also
follow the common National Guidelines for treatment of malaria as per the Drug Policy 2010.
The aims of the Malaria case management are:
To provide prompt and complete treatment to all suspected/ confirmed cases of malaria
To prevent progression of mild cases of malaria in to severe or complicated from of
malaria
To prevent deaths from severe and complicated malaria
To prevent transmission of malaria
To minimize risk of spread of drug resistant parasites by use of effective drugs in
appropriate dosage by everyone.
Diagnosis and Treatment for Malaria
Diagnosis &Treatment
All fever cases diagnosed as malaria by either RDT or microscopy should be promptly given
effective treatment. The medicine chosen will depend upon whether the patient has vivax
Dte. of National Vector Borne Disease Control Programme (NVBDCP) | Page-2
, malaria or falciparum malaria as diagnosed by the blood test. The flow charts in different
settings for diagnosis and drug selection for the treatment of malaria are as under:
Where microscopy result is available within 24 hours
Suspected malaria case
Take slide and send for microscopic examination
Result ?
Positive for Positive for Positive for Negative
P. vivax P. falciparum Mixed infecion
No anti-
Treat with: In NorthEastern In NorthEastern states: malarial
CQ 3 days + states: Age-specific Treat with: Age-specific treatment
PQ 0.25 mg ACT-AL for 3 days + ACT-AL for 3 days +
per kg body PQ Single dose on Primaquine 0.25 mg per Treat as per
weight daily for second day kg body weight daily for clinical
14 days 14 days. diagnosis
In other states:
Treat with: ACT-SP In other states:
for 3 days + PQ SP-ACT 3 days +
Single dose on Primaquine 0.25 mg per
second day kg body weight daily for
14 days.
Or
daily for 14 days
ACT-AL - Artemisinin-based Combination Therapy- Artemether - Lumefantrine
ACT-SP- Artemisinin-based Combination Therapy (Artesunate+Sulfadoxine-Pyrimethamine)
CQ - Chloroquine
PQ - Primaquine
Dte. of National Vector Borne Disease Control Programme (NVBDCP) | Page-3
of
Malaria
2013
Dte. of National Vector Borne Disease Control Programme (NVBDCP) | Page-1
, Diagnosis and Treatment of Malaria in India
For malaria control, the main thrust of the National Vector Borne Diseases Control
programme (NVBDCP) is on early diagnosis and prompt, complete and effective treatment.
Malaria diagnosis is carried out by microscopic examination of blood films collected by
active and passive agencies. Health agencies and volunteers treating fever cases in
inaccessible areas are being provided with Rapid Diagnostic Test (RDT) kits (Pf specific so
far and now Bivalent RDT) for diagnosis of Malaria cases so as to provide full radical
treatment to the confirmed cases. It is stressed that all fever cases should be suspected of
malaria after ruling out other common causes and should be investigated for confirmation of
malaria by Microscopy or Rapid Diagnostic Kit (RDK) so as to ensure treatment with full
therapeutic dose with appropriate drug to all confirmed cases. Presumptive treatment of
malaria with a single dose of chloroquine has been stopped. In all cases of suspected
malaria which cannot be immediately confirmed by tests, full treatment with chloroquine for
3 days should be given. The malaria case management is very important for preventive
serious cases and death due to malaria. So, the private healthcare providers should also
follow the common National Guidelines for treatment of malaria as per the Drug Policy 2010.
The aims of the Malaria case management are:
To provide prompt and complete treatment to all suspected/ confirmed cases of malaria
To prevent progression of mild cases of malaria in to severe or complicated from of
malaria
To prevent deaths from severe and complicated malaria
To prevent transmission of malaria
To minimize risk of spread of drug resistant parasites by use of effective drugs in
appropriate dosage by everyone.
Diagnosis and Treatment for Malaria
Diagnosis &Treatment
All fever cases diagnosed as malaria by either RDT or microscopy should be promptly given
effective treatment. The medicine chosen will depend upon whether the patient has vivax
Dte. of National Vector Borne Disease Control Programme (NVBDCP) | Page-2
, malaria or falciparum malaria as diagnosed by the blood test. The flow charts in different
settings for diagnosis and drug selection for the treatment of malaria are as under:
Where microscopy result is available within 24 hours
Suspected malaria case
Take slide and send for microscopic examination
Result ?
Positive for Positive for Positive for Negative
P. vivax P. falciparum Mixed infecion
No anti-
Treat with: In NorthEastern In NorthEastern states: malarial
CQ 3 days + states: Age-specific Treat with: Age-specific treatment
PQ 0.25 mg ACT-AL for 3 days + ACT-AL for 3 days +
per kg body PQ Single dose on Primaquine 0.25 mg per Treat as per
weight daily for second day kg body weight daily for clinical
14 days 14 days. diagnosis
In other states:
Treat with: ACT-SP In other states:
for 3 days + PQ SP-ACT 3 days +
Single dose on Primaquine 0.25 mg per
second day kg body weight daily for
14 days.
Or
daily for 14 days
ACT-AL - Artemisinin-based Combination Therapy- Artemether - Lumefantrine
ACT-SP- Artemisinin-based Combination Therapy (Artesunate+Sulfadoxine-Pyrimethamine)
CQ - Chloroquine
PQ - Primaquine
Dte. of National Vector Borne Disease Control Programme (NVBDCP) | Page-3
