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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
close this folder4. Diagnosis of malaria
View the document4.1 Clinical diagnosis
View the document4.2 Parasitological diagnosis
View the document4.3 Where malaria transmission is low to moderate and/or unstable
View the document4.4 In stable high-transmission settings
View the document4.5 Malaria parasite species identification
View the document4.6 In epidemics and complex emergencies
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
open this folder and view contentsAnnexes

4.4 In stable high-transmission settings

Malaria is usually the most common cause of fever in children under 5 years of age in these areas. Antimalarial treatment should therefore be given to children with fever (>37.5 °C) or a history of fever and no other obvious cause. Malaria is the most likely cause of their illness and there is as yet no evidence to show that the benefits of parasitological diagnosis in this highly vulnerable group outweigh the risks of not treating false negatives. In children of 5 years of age and above, malaria becomes progressively less likely as a cause of fever, as immunity is acquired. In these older children and in adults, malaria diagnosis should be based on a parasitological confirmation. Parasitological diagnosis should be promoted in pregnant women, to improve the differential diagnosis of fever and to reduce unnecessary use of antimalarials in pregnancy. Parasitological diagnosis is also particularly important in settings with a high prevalence of HIV/AIDS because of the high incidence of febrile disease that is not malaria in HIV-infected patients.

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