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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
 

4.6 In epidemics and complex emergencies

In epidemic and complex emergency situations, facilities for parasitological diagnosis may be unavailable or inadequate to cope with the case-load. In such circumstances, it is impractical and unnecessary to demonstrate parasites before treatment in all cases of fever. However, there is a role for parasitological diagnosis even in these situations (see section 11.1).

Summary of recommendations on parasitological diagnosis

RECOMMENDATIONS

LEVEL OF EVIDENCE

In areas of low to moderate transmission, prompt parasitological confirmation of the diagnosis is recommended before treatment is started. This should be achieved through microscopy or, where not available, RDTs.

E

In areas of high stable malaria transmission, the prior probability of fever in a child being caused by malaria is high. Children under 5 years of age should therefore be treated on the basis of a clinical diagnosis of malaria. In older children and adults including in pregnant women, a parasitological diagnosis is recommended before treatment is started.

E

In all suspected cases of severe malaria, a parasitological confirmation of the diagnosis of malaria is recommended. In the absence of or a delay in obtaining parasitological diagnosis, patients should be treated for severe malaria on clinical grounds.

E

 

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