What is the best available treatment for malaria?
For rapid and effective case management of the disease, both early diagnosis and treatment of malaria are essential. The best available treatment, particularly for P. falciparum malaria, is artemisinin-based combination therapy (ACT).
How many cases of malaria are there worldwide?
In 2018, there were approximately 228 million cases of malaria worldwide. Approximately 405,000 people died, including close to one child every two minutes. In 2019, total global malaria spending was $2.7 billion. In order to reduce malaria mortality rates by 75%, the annual global investment will need to increase to $ 7.7 billion by 2025.
What is the purpose of the malaria control program?
CRS provides training and support to community health workers to test, diagnose, treat, and track malaria cases, helping to improve prompt access to appropriate treatment, particularly in remote or difficult-to-access areas. A patient visits a pharmacy in Niger and receives free treatment after being diagnosed with malaria.
When is presumptive treatment indicated for malaria?
“Presumptive treatment”, i.e., without prior laboratory confirmation, should be reserved for extreme circumstances, such as strong clinical suspicion of severe disease in a setting where prompt laboratory diagnosis is not available. Once the diagnosis of malaria has been made, appropriate antimalarial treatment must be initiated immediately.
Tracking progress against malaria
Each year, WHO’s World malaria report provides a comprehensive and up-to-date assessment of trends in malaria control and elimination across the globe. It tracks investments in malaria programmes and research as well as progress across all intervention areas: prevention, diagnosis, treatment, elimination and surveillance.
Reflections from the Director of the Global Malaria Programme
Where does the world stand in terms of progress towards global malaria targets? Are there any bright spots in this year’s report?
When should malaria treatment be initiated?
Ideally malaria treatment should not be initiated until the diagnosis has been established by laboratory testing. “Presumptive treatment”, i.e., without prior laboratory confirmation, should be reserved for extreme circumstances, such as strong clinical suspicion of severe disease in a setting where prompt laboratory diagnosis is not available.
How often should you have a blood smear for malaria?
However, because non-immune individuals may be symptomatic at very low parasite densities which may be initially undetectable, blood smears should be repeated every 12–24 hours for a total of three sets before the diagnosis of malaria can be ruled out.
What is the best treatment for P. falciparum?
For P. falciparum infections acquired in areas with chloroquine resistance, four treatment options are available. These include artemether-lumefantrine (Coartem™), which is the preferred option if readily available, and atovaquone-proguanil (Malarone™). These are fixed-dose combination therapies that can be used for pediatric patients ≥5 kg. Quinine sulfate plus doxycycline, tetracycline, or clindamycin is also a treatment option. For the quinine sulfate combination options, quinine sulfate plus either doxycycline or tetracycline is generally preferred to quinine sulfate plus clindamycin because there are more data on the efficacy of quinine sulfate plus doxycycline or tetracycline. Quinine should be given for 3 days, except for infections acquired in Southeast Asia where 7 days of treatment is required. The fourth option, mefloquine, is associated with rare but potentially severe neuropsychiatric reactions when used at treatment dose. We recommend this option only when the other options cannot be used. In addition, mefloquine is not recommended for infections acquired in certain parts of Southeast Asia due to drug resistance. Once a treatment regimen is started, if it is being tolerated, there is no need to switch regimens even if a preferred regimen becomes available.
How often should you check parasite density?
falciparum infection, patients should be hospitalized to monitor clinical response, and check parasite density every 12–24 hours until clinical presentation improves and a decrease in parasite density becomes apparent.
How to diagnose malaria?
Laboratory diagnosis of malaria can be made through microscopic examination of thick and thin blood smears. Thick blood smears are more sensitive in detecting malaria parasites because the blood is more concentrated allowing for a greater volume of blood to be examined; however, they are more difficult to read.
What are the symptoms of malaria?
Symptoms of malaria are generally non-specific and most commonly consist of fever, headache, malaise, weakness, gastrointestinal distress (nausea, vomiting, diarrhea), neurologic complaints (dizziness, confusion, disorientation, coma), back pain, myalgia, chills, and/or cough. The diagnosis of malaria should also be considered in any person ...
Can malaria be confirmed?
If the diagnosis of malaria is suspected and cannot be confirmed or if the diagnosis of malaria is confirmed but species determination is not possible, antimalarial treatment effective against chloroquine-resistant P. falciparum must be initiated immediately and revisited once confirmatory results become available.
About Malaria
Our Work
- In 2019, CRS's $154 million portfolio of 17 malaria projects reached 86 million people in 12 countries. Our programs focus on the people most vulnerable to malaria-related morbidity and mortality – children under 5 and pregnant women. We address the illness at household, community and facility levels. And we emphasize prevention, community and faci...
Prevention
- CRS promotes the use of insecticide-treated nets (ITNs) through both routine and mass distributions, indoor residual spraying, intermittent preventive therapy for pregnant women (IPTp) and seasonal malaria chemoprevention (SMC) in the Sahel region. 1. To date, CRS has distributed more than 113 million ITNs in The Gambia, Ghana, Guinea, Madagascar, Niger, Nigeria and Sene…
Testing, Diagnosis and Treatment
- At the local level, CRS has a strong understanding of the challenges that malaria programs need to address, including working with hard-to-reach demographics such as young mothers as well as community members with limited education and other marginalized groups. CRS provides training and support to community health workers to test, diagnose, treat, and track malaria cases, helpi…
Mobile Technology For Rapid Data Collection
- Over 60% of CRS’ malaria programs use mobile technologyto improve speed and accuracy of data collection, enable simple analysis and use of complex data, or increase adherence to malaria treatment guidelines. In 2019, CRS supported the first synchronized, cross-border LLIN distribution in Senegal and The Gambia. CRS supported GIS mapping of 1,454 communities alon…
Surveillance, Monitoring and Evaluation
- In all its malaria programs, CRS works with existing national health management information systems (HMIS) to collect high quality and timely data, ensure consistent and verifiable reporting and, as needed, strengthen the capacity of these systems. In several countries, CRS is supporting the roll-out of the District Health Information System 2 to streamline reporting from the district t…
Accountability
- CRS recognizes the need for mechanisms that ensure accountability to project beneficiaries. For example, through its Global Fund Sub-Recipient grant in Cambodia, CRS is assisting the local government to improve the client-provider interface and strengthen mechanisms for community participation (Village Health Support Groups, Health Center Management Committees) to impro…
Learning
- In its programs, CRS emphasizes the need to document, analyze and apply learningat the project, sector and agency level, and share that learning with stakeholders, practitioners and policymakers. The CRS Monitoring, Evaluation, Accountability and Learning (MEAL) community has developed a learning framework that fosters intentional learning. Under the MEAL policies a…