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Malaria Treatment Guidelines USA

This document outlines the algorithm for diagnosing and treating malaria in the United States. It begins with evaluating patients who present with fever and travel history to a malaria-endemic area or who are clinically suspected of having malaria. This involves performing blood smears to check for the malaria parasite. Based on the blood smear results and species identified, treatment is determined as either uncomplicated malaria using oral medications like chloroquine, or severe malaria requiring intravenous medications in intensive care. Follow-up blood smears are also recommended to monitor the patient's response to treatment.

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Adriel Sebastian
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93 views1 page

Malaria Treatment Guidelines USA

This document outlines the algorithm for diagnosing and treating malaria in the United States. It begins with evaluating patients who present with fever and travel history to a malaria-endemic area or who are clinically suspected of having malaria. This involves performing blood smears to check for the malaria parasite. Based on the blood smear results and species identified, treatment is determined as either uncomplicated malaria using oral medications like chloroquine, or severe malaria requiring intravenous medications in intensive care. Follow-up blood smears are also recommended to monitor the patient's response to treatment.

Uploaded by

Adriel Sebastian
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Algorithm for Diagnosis and Treatment of Malaria in the United States*

CDC Malaria Hotline: (770) 488-7788 or (855) 856-4713 (toll free), Monday–Friday, 9 am–5 pm EST;
(770) 488-7100 after hours, weekends, and holidays

Fever and history of travel to malaria-endemic


area, or clinical suspicion of malaria
Evaluation

Disposition
Perform thick and thin blood smears
and read on the same day**
Medication

No Blood smear Yes


positive?

Repeat blood smears every


12–24 hours From smear: calculate parasite density
(total of 3 times) and determine species

No Blood smear Yes


positive? Evaluate clinical status and
disease severity

Consider alternate
diagnosis Uncomplicated Severe malaria and/or patient
malaria unable to tolerate oral
medication, regardless of species†

P. falciparum, P. knowlesi, P. ovale or P. vivax acquired in P. vivax


P. malariae area without chloroquine acquired in area Admit to intensive care unit
or species not yet
identified† resistance with Call CDC
chloroquine
resistance
Admit to hospital and monitor
for disease progression Chloroquine or Chloroquine or Intravenous artesunate
Hydroxychloroquine‡ Hydroxychloroquine‡
If needed, interim treatment:
P. falciparum or species Artemether-lumefantrine
not yet identified† or
Artemether-lumefantrine Atovaquone-proguanil
P. knowlesi or or
Atovaquone-proguanil Quinine
or or, if no other options,
Quinine plus tetracycline Mefloquine
Chloroquine or or doxycycline or
Hydroxychloroquine‡ clindamycin
or, if no other options,
Mefloquine
P. falciparum Monitor parasite density
P. falciparum acquired P. falciparum every 12–24 hours
acquired in area with
in area with acquired in area with
no chloroquine
chloroquine resistance mefloquine resistance
resistance PLUS

Artemether-lumefantrine Artemether-lumefantrine If not G6PD deficient by Administer follow on treatment


(preferred) (preferred) quantitative testing: after intravenous artesunate:†
Chloroquine or
or or Artemether-lumefantrine
Hydroxychloroquine‡ Primaquine (any prior regimen
Atovaquone-proguanil Atovaquone-proguanil for acute infection) or or
or or Tafenoquine (only if Atovaquone-proguanil
Quinine plus tetracycline Quinine plus tetracycline chloroquine used for acute or
or doxycycline or or doxycycline or infection; not for children <16 Quinine and doxycycline (or
clindamycin clindamycin years old) clindamycin)
or, if no other options, or, if no other options,
Mefloquine Mefloquine

Footnotes:
* Treatment for special populations (children and pregnant women) can be found in the CDC Treatment Guidelines and
Treatment Table.
** If rapid diagnostic test performed, smear should also be performed with results available as soon as possible.
† If species later identified as P. vivax or P. ovale, add primaquine if not G6PD deficient by quantitative testing. Tafenoquine can

only be used if chloroquine or hydroxychloroquine used for acute infection.


‡Drug options for chloroquine-resistant P. falciparum may be used.

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