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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
close this folder7. Treatment of uncomplicated P. Falciparum malaria10
View the document7.1 Assessment
View the document7.2 Antimalarial combination therapy
View the document7.3 The choice of artemisinin-based combination therapy options
View the document7.4 Practical aspects of treatment with recommended ACTs
View the document7.5 Incorrect approaches to treatment
View the document7.6 Additional aspects of clinical management
View the document7.7 Operational issues in treatment management
View the document7.8 Management of treatment failures
View the document7.9 Treatment in specific populations and situations
View the document7.10 Coexisting morbidities
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
 

7.5 Incorrect approaches to treatment

In endemic regions, some semi-immune malaria patients could be cured using partial treatment with effective medicines (i.e. use of regimens that would be unsatisfactory in patients with no immunity). This had led in the past to different recommendations for patients considered to be semi-immune and those considered to be non-immune. Another potentially dangerous practice is to give only the first dose of the treatment course for patients with suspected but unconfirmed malaria, with the intention of giving full treatment if the diagnosis is eventually confirmed. Neither practice is recommended. If malaria is suspected and the decision to treat is made, then a full effective treatment is required whether or not the diagnosis is confirmed by a test.

With the exception of artemether-lumefantrine, the partner medicines of all other ACTs have been previously used as monotherapies, and still continue to be available as such in many countries. Their continued use as monotherapies can potentially compromise the value of ACTs by selecting for drug resistance. The withdrawal of artemisinins and other monotherapies is recommended.

Summary of recommendations on treatment approaches that should be avoided

RECOMMENDATIONS

LEVEL OF EVIDENCE

Partial treatments should not be given even when patients are considered to be semi-immune or the diagnosis is uncertain. A full course of effective treatment should always be given once a decision to give antimalarial treatment has been reached.

E

The artemisinins and partner medicines of ACTs should not be available as monotherapies.

E

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