Treatment

• admit to hospital with infectious disease expertise

• supportive measures including fluid replacement

• P. vivax, P. ovale, P. malariae 4 7 (check G6PD first)

chloroquine 4 tabs (o) statim, then 2 tabs in 6 hours, then 2 tabs on day 2 and day 3 +

primaquine 15 mg (o) daily for 14 days

• P. falciparum 4 7 uncomplicated:

quinine sulphate 600 mg (o) 8 hourly, 7 days +

doxycycline 100 mg (o) daily, 7 days or

Fansidar, 3 tablets on day 3

or (alone as alternative to above) mefloquine (for breakthrough dose) complicated:

quinine dihydrochloride 20 mg/kg IV (over 4 hours) then after 4-hour gap 10 mg/kg IV 8 hourly until improved then quinine (o) 7 days + Fansidar statim

Note: Check for hypoglycaemia.

Beware if antimalarial use in previous 48 hours.

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