Treating malaria

Each year, more than 400 000 people die of malaria – a treatable disease. 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).

The primary objective of treatment is to ensure the rapid and full elimination of Plasmodium parasites from a patient’s bloodstream in order to prevent an uncomplicated case of malaria from progressing to severe disease or death. From a public health perspective, effective treatment also reduces transmission of the infection to others by reducing the infectious reservoir and by preventing the emergence and spread of resistance to antimalarial medicines.

Patients with suspected malaria should have parasitological confirmation of diagnosis with either microscopy or rapid diagnostic test (RDT) before antimalarial treatment is started. Treatment based on clinical grounds should only be given if diagnostic testing is not immediately accessible within 2 hours of patients presenting for treatment. Prompt treatment – within 24 hours of fever onset – with effective and safe antimalarial is necessary to effect a cure and prevent life-threatening complications.

Use of oral artemisinin-based monotherapy (oAMT) is considered a contributing factor to the development and spread of resistance to artemisinins. WHO has urged malaria-endemic countries to take measures to halt the production and marketing of oAMT, and to promote access to quality-assured ACTs for the treatment of falciparum malaria.