Treatment of malaria by a community health worker CHWs

Can only treat simple malaria in non-pregnant individuals and in children with a body weight over 5kg. All other cases of malaria MUST be referred. Zambia uses artemisinin combination therapies (ACTs) for treatment of uncomplicated or simple malaria.

Available treatment

1. Artemether-lumefantrine (AL) treatment for malaria

AL is the current national malaria treatment policy choice for simple malaria in adults and children who weigh at least 5 kg. AL is a combination of two active substances, artemether and lumefantrine, both of which work together to kill the parasites that cause malaria.


2. Dihydroartemisinin-piperaquine (DHAp) treatment for malaria

DHAp is the alternative first-line treatment for uncomplicated malaria in Zambia. It is given orally over three days.

Note: Policy wise, the drug has been reserved for Mass Drug Administration (MDA)

  • It is currently used as an accelerator to compliment other interventions such as step D to speed up the reduction of the burden of malaria within a defined geographical area.
  • In this case, all individuals may be given the drug irrespective of whether they are positive and negative or without doing an RDT test.

DHAP dosage



Who is not recommended for DHAp:

  • Children less than three (3) months old
  • All pregnant women in their first trimester
  • Any person with a condition known to prolong the QTC interval (such as heart problems)
  • Any person with an allergy to artemisinin compounds or piperaquine

3. Rectal artesunate

Rectal artesunate is a suppository dosed at 10 mg/kg of body weight as a pre-referral treatment of presumptive or confirmed severe P. falciparum malaria.

Who is eligible to be administered RAS?

  • RAS is most effective for children from six months and less than six years old (6 months to < 6 years).
  • Children younger than 6 months old should not be treated with RAS but be referred straight to the health facility where they can be attended to by the health workers.
  • Children who are older than 6 years should not also be treated with RAS but referred to the health facility. • Rectal artesunate is only the first stage of treatment. The patient should be immediately referred to the nearest hospital or health facility where the full required treatment for severe malaria can be provided.
How to administer RAS- 4 Stages

Stage 1: Prepare


Stage 2:  Administer


Stage 3 and 4: Transfer and follow up

f


Troubleshooting 


Notes


Malaria treatment key points

  • If a patient vomits within 30 minutes of taking the drug, they must be given the drug again.
  • If a patient tests negative but has fever or any other symptoms, refer to the health Centre.
  • If a client has signs and symptoms and tests
  • RDT-positive but was treated for malaria within past two weeks, refer to the health Centre. 
ALWAYS CRUSH/DISSOLVE A PILL FOR CHILDREN.

Last modified: Monday, 15 June 2020, 11:01 AM