Treatment of malaria

Antimalarial treatment must always be started as soon as malaria is diagnosed. Artemisinin Combination Therapies (ACTs) are the most effective WHO recommended treatment of uncomplicated malaria caused by the P. falciparum parasite. The treatment is based on 2 active ingredients with different mechanisms of action.  Currently there are 5 ACTs, based on different classes of  drugs (WHO, 2015).

After parasitological confirmation of diagnosis with either microscopy or rapid diagnostic test, the patient can take antimalarial treatment.

Treatment of uncomplicated P. falciparum malaria

A confirmed case of malaria is treated with the following ACTs:

  • Artemether+lumefantrine
  • Artesunate + amodiaquine
  • Artesunate + mefloquine
  • Dihydroartemisinin + piparaquine
  • Artesunate+sulfadoxine-pyrimethamine (SP)

The treatment lasts 3 days. The most used ACT in Rwanda is called Coartem. Coartem tablets contain a fixed combination of 2 antimalarial active ingredients, artemether, an artemisinin derivative, and lumefantrine.

Treatment of severe malaria

Patients with severe malaria are treated with intravenous or intramuscular Artesunate for at least 24 hours and until they can tolerate oral medication. Once a patient has received at least 24 hours of parenteral therapy and can tolerate oral therapy, complete treatment with 3 days of ACT (add single dose primaquine in areas of low transmission)(WHO, 2015).