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close this bookGuidelines for the Treatment of Malaria (WHO; 2006; 266 pages) View the PDF document
View the documentGlossary
View the documentAbbreviations
open this folder and view contents1. Introduction
View the document2. The clinical disease
open this folder and view contents3. Treatment objectives
open this folder and view contents4. Diagnosis of malaria
open this folder and view contents5. Resistance to antimalarial medicines9
open this folder and view contents6. Antimalarial treatment policy
open this folder and view contents7. Treatment of uncomplicated P. Falciparum malaria10
open this folder and view contents8. Treatment of severe falciparum malaria14
open this folder and view contents9. Treatment of malaria caused by P. vivax, P. ovale or P. malariae19
View the document10. Mixed malaria infections
close this folder11. Complex emergencies and epidemics
View the document11.1 Diagnosis
View the document11.2 Use of rapid diagnostic tests in epidemic situations
View the document11.3 Management of uncomplicated malaria in epidemics
View the document11.4 Areas prone to mixed falciparum/vivax malaria epidemics
View the document11.5 Use of gametocytocidal drugs to reduce transmission
View the document11.6 Anti-relapse therapy in vivax malaria epidemics
View the document11.7 Mass treatment
open this folder and view contentsAnnexes
 

11.1 Diagnosis

In epidemic and complex emergency situations, facilities for laboratory diagnosis may be either unavailable or so overwhelmed with the case-load that parasite-based diagnosis is impossible. In such circumstances, it is impractical and unnecessary to demonstrate parasites before treatment in all cases of fever. Once an epidemic of malaria has been confirmed, and if case numbers are high, treatment based solely on the clinical history is appropriate in most cases, using a full treatment course. However, parasite-based diagnosis is essential to:

• diagnose the cause of an epidemic of febrile illness,
• monitor and confirm the end of an epidemic,
• follow progress in infants, pregnant women, and those with severe malaria.


As the epidemic wanes, the proportion of fever cases investigated parasitologically can be increased. It is important to monitor the clinical response to treatment wherever possible, bearing in mind that other infections may also be present. In mixed falciparum/vivax epidemics, parasitaemia should be monitored in order to determine a species-specific treatment.

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