Can You Cure Malaria?
The only thing good about malaria is, it can be cured without much agony. But like every other disease the efficiency of the treatment depends on the correct diagnosis in time. An uncomplicated case has to be distinguished from complicated one to start a promising treatment and prevention of relapses. Quinine based drugs are old generation drugs. Currently, artemisinin derivatives are drugs of choice for example, artesunate, and artemether. Apart from complicated cases, a medical practitioner has to make sure which type of infection it is i.e. vivax or falciparum.
Curing of Uncomplicated Malaria Cases
Malaria diagnosed by RDT or microscopic measures should be prescribed complete drug course.
Treatment for P. vivax infection
Full therapeutic dose consist of chloroquine 25 mg/kg over the period of three days. To prevent relapsing of the fever, primaquine 0.25 mg/kg for two weeks under supervised condition as patient feels this drug unnecessary and tends to miss the dose. However, primaquine should be avoided in G6PD deficiency patients, pregnant women and newborn babies.
Treatment for P. Falciparum Infection
Standard treatment for falciparum malaria is ACT (Artemisinin Combination Therapy). For therapy initiation, Artesunate for 3 days along with Sulphadoxine – Pyremethamine for a single day is prescribed. This has to be accompanied by Primaquine (0.75 mg/kg) on the second day. Just to take resistance to these drugs into the account, Technical advisory committee formulated another tablet with Artemether 20 mg and Lumefantrine 120 mg. newer drugs are contraindicated in pregnant women during first trimester and children weighing below 5 kg.
Treatment in Pregnant Women
In cases of falciparum malaria quinine is the only safe drug that can be given during first trimester of pregnancy. To treat cases of women during second and third trimesters, Artemisinin Combination Therapy is preferred. Cases with vivax infection have to be treated with chloroquine as primaquine is contraindicated in pregnancy.
Treatment for Mixed Infection
Falciparum type of mixed infections has to be considered as cases of falciparum malaria and should be treated like one. Resistant cases or cases not responding to Artemisinin Combination Therapy should be treated with oral dosage of quinine (with addition of doxycycline or tetracycline). However, there is requirement of reporting such resistant cases to the concerned authority or officiating employee or in-charge of the State Malaria Committee.
If the case of mixed infection involves other two species of the Protozoa, P. ovale should be treated as P. vivax and P. malariae should be seen as P. falciparum.
How Cases Of Severe Malaria Should Be Cured?
It is none less than an emergency situation when a case of complicated malaria presents with severe condition and treatment has to be started right away as per the symptoms. Before referring or admitting the patient, the attending health worker or doctor should not forget to perform RDT and taking blood sample for smear examination. As soon as malaria is confirmed, inject a dose of quinine or artemisinin derivative perenterally if cerebral malaria is suspected. Thing to be noted is injection has to be given along with one of the few other drugs irrespective of presence of any type of resistance towards chloroquine in the area.
Though taking drugs as a prophylactic measure in protozoan infections carry some downsides for example, development of resistance towards certain drug or class of drug and eventually will become unreliable yet, researches prove that it can be used as an efficient tool to reduce risk of some life threatening diseases drastically. Such type of treatment is recommended to frequent travelers and those from non-endemic region.
- Doxycycline should be taken at least a day prior to arrival.
- Chloroquine requires to be taken 7 days before arrival.
- To achieve high pre-travel blood concentration few drugs are started two to three weeks prior to the journey e.g. mefloquine.
Hence, we can say apart from some gruesome presentation of symptoms, malaria is curable disease with almost cent percent result on timely diagnosis.