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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 2. Adaptation of WHO malaria treatment guidelines for use in countries

A2.1 Background

WHO has recently convened technical consultations aimed at developing guidelines for the treatment of malaria.22

22 The guidelines development process is described in Annex 1.


The guidelines are generic in nature and should therefore be adapted by regions and countries alike to take account of local conditions, especially when formulating implementation and scale-up strategies.

A number of malaria endemic countries have not yet elaborated national malaria treatment guidelines, although treatment protocols may be available at the health-care provider level. Furthermore, existing national guidelines need to be updated as many countries, especially in sub-Saharan Africa, are adopting and starting to implement policies specifying the use of artemisinin combination therapies (ACTs).

This annex provides orientation and guidance on the process countries should follow in adapting the content of the generic malaria treatment guidelines provided in the main document.

A2.2 The development process

The ministry of health should take the lead in the process of developing national malaria treatment guidelines.23

23 The preparation of the treatment guidelines is only one component of implementation of antimalarial treatment policy.


The proposed steps include the following.

A national workshop on the malaria treatment guidelines is the first step at country level. This workshop will review any current national malaria treatment guidelines, identify specific issues that need to be addressed and provide major policy recommendations.

Drafting/updating the national malaria treatment guidelines. Following the national workshop, the national malaria case management committee (or its equivalent) should spearhead the development of new national malaria treatment guidelines in accordance with the standard outline set out below.

A consensus workshop on the national malaria treatment guidelines should then be arranged to present, discuss and adopt the draft national malaria treatment guidelines.

Finalization and dissemination. The national malaria treatment guidelines are finalized, officially endorsed and disseminated.


A2.3 The content

It is recommended that national malaria treatment guidelines are presented in a similar way as WHO Guidelines on the Treatment of Malaria. The following outline is suggested:

1. General introduction

• Epidemiological situation and parasite distribution
• National drug resistance pattern


2. Diagnosis of malaria

• Clinical diagnosis
• Role of parasitological diagnosis


3. Treatment of P. falciparum malaria or the most prevalent species in the country

• Uncomplicated malaria

- definition
- treatment objectives
- treatment recommendations
- treatment in specific populations and situations


• Severe malaria

- definition
- treatment objectives
- treatment recommendations
- pre-referral treatment options
- management in epidemic situations


4. Treatment of malaria caused by other species

5. Disease management at the different levels of the health care delivery system

6. Annexes - Relevant annexes should be attached to provide more detailed information on, for example, dosages of drugs, specific data on therapeutic efficacy of antimalarial medicines in the country, other available evidence for treatment recommendation, etc.

 

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