Malaria fever is viral by mosquitoes.Treatment obviously depends on the type of infection. Patients with P. falciparum malaria should be evaluated thoroughly in view of potential seriousness of the disease and possibility of resistance to anti malarial drugs.
All patients with malaria should be carefully and thoroughly assessed for complications of malaria. Acute, life-threatening complications occur only in P. falciparum malaria. Malaria is probably the only disease of its kind that can be easily treated in just 3 days, yet if the diagnosis and proper treatment are delayed, it can kill the patient very quickly and easily.
- All cases of severe malaria should be presumed to have P. falciparum malaria or treated as such.
- If there is any uncertainty about the drug sensitivity of the parasite, it is safer to treat these cases as chloroquine resistant malaria with drugs like quinine or artemisinin.
- All cases of severe malaria should be admitted to the hospital for proper evaluation, treatment and monitoring.
- All cases of severe malaria should be treated with injectable antimalarials (quinine, artemisinin derivatives) so as to ensure adequate absorption and plasma drug levels. Once the patientg is able to take oral medications, artimisinin combination therapy must be used as per recommendations.
- All associated conditions should be carefully assessed and treated.
- Patient’s age and weight should be recorded so as to administer adequate doses of anti malarial drugs.
- Functional capacity- independent, dependent, bed ridden etc. All patients with severe prostration and who are looking ill should be admitted to a hospital and monitored.
- Patients with nausea and vomiting should be given anti emetic drugs to ensure adequate treatment. While high-grade fever frequently stimulates vomiting, this may be further aggravated by anti malarial drugs. Therefore it is better to avoid administration of oral antimalarials at the height of fever. One can wait for the fever to subside before taking the drugs. If the patient vomits within one hour of taking the anti malarial drugs, the same should be re-administered. In case of persistent vomiting, patient should be admitted and vomiting should be controlled with parenteral anti emetics. Parenteral anti malarials are needed only in cases of severe malaria or uncontrolled vomiting.
- Adequate hydration should be ensured.