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Malaria Treatment
Not diagnosing malaria and treating the disease promptly may lead to febrile illness and significant morbidity and mortality. The most susceptible population includes children, pregnant women, and patients with immune problems.
Pharmacologic treatment is done with antimalarial medications such as quinidine gluconate and artesunate. Sometimes quinidine is administered intravenously, and when it does, patients should monitor their blood glucose to prevent hypoglycemia. There is drug resistance to antimalarial medications in endemic areas, so the treatment depends on the endemic area where the patient traveled. For example, patients who recently were to Africa are probably resistant to chloroquine and antifolates.
Artemisinins are one of the newest malarial medications, and they are usually administered along with other drugs to prevent a relapse. In uncomplicated malaria in the United States, lumefantrine and artemether tablets are preferred instead of intravenous treatment. The latter is only used in severe malaria or when patients do not tolerate oral therapy.
In some cases, patients with severe malaria reach a volume of parasitemia that requires hospitalization. Patients should be hospitalized if more than 5% of red blood cells are infected by the disease or after developing central nervous system symptoms. Inpatient treatment should include blood smears every day to check the parasite’s response to the treatment.
