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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
open this folder and view contents11. Complex emergencies and epidemics
close this folderAnnexes
View the documentAnnex 1. The guidelines development process
View the documentAnnex 2. Adaptation of WHO malaria treatment guidelines for use in countries
View the documentAnnex 3. Pharmacology of antimalarial drugs
View the documentAnnex 4. Antimalarials and malaria transmission
View the documentAnnex 5. Malaria diagnosis
View the documentAnnex 6. Resistance to antimalarials
View the documentAnnex 7. Uncomplicated P. falciparum malaria
View the documentAnnex 8. Malaria treatment and HIV/AIDS
View the documentAnnex 9. Treatment of severe P. falciparum malaria
View the documentAnnex 10. Treatment of P. vivax, P. ovale and P. malariae infections
 

Annex 1. The guidelines development process

A1.1 Treatment recommendations

The WHO Guidelines for the Treatment of Malaria were developed in accordance with the guidance established by WHO for the formulation of such guidelines.21

21Guidelines for guidelines. Geneva, World Health Organization, 2003 (document EIP/GPE/EQC/2003.1).


The development process was undertaken at a technical consultation on malaria treatment guidelines and by the Technical Guidelines Development Group, chaired by Professor Nick White (participants are listed below). Conflict of interest statements were received from all participants, and no conflict of interest was declared by any of the participants. The first technical consultation was convened in April 2004, at which the target audience for the guidelines was defined and the scope of the guidelines and key questions to be addressed were determined.

Following the first meeting, contracts for systematic search and reviews of relevant evidence were awarded to research groups from two institutions: the Liverpool School of Tropical Medicine, Liverpool, England and Mahidol University, Bangkok, Thailand. The search strategies employed included a search of the following databases:

• the Cochrane Infectious Diseases Group trials register (up to June 2004),*

• the Cochrane Central Register of Controlled Trials (CENTRAL) published in The Cochrane Library (Issue 2, 2004),*

• MEDLINE (1966 to June 2004),

• EMBASE (1980 to June 2004),

• LILACS (1982 to June 2004).


The evidence for RCTs was assembled in collaboration with Clinical Evidence, a product of BMJ Knowledge.

The following search terms were used:

• malaria (free text),
• malaria (controlled vocabulary, MESH or EMTREE).


The terms were used in combination with the search strategy for retrieving randomized and controlled clinical trials developed by The Cochrane Collaboration. Key words relative to currently available antimalarial drugs were used for each section of the review. Where indicated, specific authors and research groups were contacted for more information on published work and work in progress.

In formulating recommendations, evidence was graded in order of priority as follows:

• formal systematic reviews, such as Cochrane reviews, including more than one randomized control trial,

• comparative trials without formal systematic review,

• observational studies (e.g. surveillance, pharmacological data),

• expert opinion/consensus.


The Technical Guidelines Development Group held its first meeting in August 2004 and produced a preliminary draft that was presented and revised at the second technical consultation in October 2004. The revised draft of the guidelines was sent out for external peer review in November 2004. At a subsequent meeting of the Technical Guidelines Development Group in January 2005, the document was revised further in the light of comments received. The Guidelines development process and publication was fully funded by WHO. It is planned that the evidence will be reviewed on an annual basis, and that the guidelines will be updated periodically. Similarly a mechanism for peroidic monitoring and evaluating the use of the treatment guidelines in countries would be established.

A1.2 Members of the Technical Guidelines Development Group

Temporary advisers

Dr D. Baza, National Malaria Control Programme Manager, Ministry of Health, Burundi

Dr D. Bethell*, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

Professor A. Bjorkman, Division of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden

Professor M. Boulos, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

Professor M. A. Faiz, Department of Medicine, Dhaka Medical College, Bangladesh

Professor P. Garner*, Liverpool School of Tropical Medicine, Liverpool, England

Professor O. Gaye, Service de Parasitologie, Faculté de Médecine, Université Cheikh Anta Diop, Dakar-Fann, Senegal

Dr T. Ghebremeskel, National Malaria Programme Manager, Ministry of Health, Asmara, Eritrea

Dr S. Hill*, Discipline of Clinical Pharmacology, Faculty of Medicine & Health Sciences, University of Newcastle, Newcastle Mater Hospital, Newcastle, Australia

Dr K. Jones*, Clinical Research Fellow, Liverpool School of Tropical Medicine, Liverpool, England

Dr S. Lutalo, Consultant Physician, Harare Central Hospital, Harare, Zimbabwe

Dr A. McCarthy, Director, Tropical Medicine and International Division of Infectious Diseases, Ottawa Hospital General Campus, Ottawa, Canada

Dr O. Mokuolu*, Consultant Paediatrician, University of Ilorin Teaching Hospital, Ilorin, Nigeria

Dr S. Nyirenda, Consultant Physician, Department of Medicine, University Teaching Hospital, Lusaka, Zambia

Dr E. Tjitra*, Senior Researcher, National Institute of Health & Development, Ministry of Health, Jakarta, Indonesia

Dr L.S. Vestergaard, Laboratory of Parasitic Diseases, Statens Serum Institut, and Department of International Health, University of Copenhagen, Copenhagen, Denmark

Professor N. White* (Chairman) Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

WHO Secretariat

Dr D. Bell, Malaria and Parasitic Diseases, WHO Regional Office for the Western Pacific, Manila, Philippines

Dr A. Bosman, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr C. Delacollette, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr M. Gomes, UNDP/UNICEF/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland

Dr R. Gray, Essential Drugs and Medicine, World Health Organization, Geneva, Switzerland

Dr K.N. Mendis*, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr F. Nafo-Traoré, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr B.L. Nahlen, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr P.E. Olumese* (Secretary), Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr C. Ondari*, Essential Drugs and Medicine, World Health Organization, Geneva, Switzerland

Dr R. Ridley*, UNDP/UNICEF/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland

Dr A.E.C. Rietveld*, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr P. Ringwald, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr I. Sanou, Malaria, WHO Regional Office for Africa, Harare, Zimbabwe.

Dr A. Schapira, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

Dr T. Sukwa*, Malaria, WHO Regional Office for Africa, Harare, Zimbabwe

Dr T. Tantorres, Evidence and Information for Policy, World Health Organization, Geneva, Switzerland

Dr W. Taylor, UNDP/UNICEF/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland

Dr Y. Touré, UNDP/UNICEF/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland

Dr W.M. Were, Roll Back Malaria Department, World Health Organization, Geneva, Switzerland

* Members of the Guidelines drafting committee.

 

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