TREATMENT OF MALARIA IN PAEDITRICS: A REVIEW

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Management of Chloroquine Sensitive Complicated Malaria in Children:

Start with Chloroquine injection & follow up with Primaquine Tablet (to check spread)

Chloroquine injection

Primaquine Tablet

Children


Children


By very slow I.V infusion*

Initial Dose
10 mg / kg over a period of not less than 8 hrs

Followed by
5 mg / kg every 8 hrs until a total dose of 25 mg / kg has been given

By I.M or S.C*

(when I.V infusion is not possible) 2.5 mg / kg every 4 hrs

OR

3.5 mg / kg every 6 hrs. Until a total dose of 25 mg / kg has been given


Children < 1 year : Not Recommended

Children over 1 year : Primaquine 0.5mg – 0.75 mg / kg in single dose.

Note: chloroquine doses are in terms of bases.

*Till the patient can take oral Chloroquine.

Reference: The Use of Antimalarial Drugs: Report of WHO Informal Consultation 13th-17th Nov, 2000.

Management of Chloroquine Resistant Complicated Malaria in Children:

Start with Quinine & follow up with Primaquine Tablet (to check spread)

(OR)

Recommended β Arteether Inj

1 st Line Theory

2 nd Line Theory

Quinine Injection

Primaquine Tablet

β Arteether Inj

Loading dose

20 mg /kg by I.V infusion over 4 hrs


Followed by*

10 mg / kg every 12 hrs for 7-10 days

Children < 1 year: not recommended
children over 1 year: Primaquine Tab 0.5-0.75 mg / kg in a single dose

3 mg / kg body weight/ day by I.M.Injection over a period of 3 days i.e. β Arteether Inj.

Note: Quinine doses are in terms of salt.

*Till the patient can take oral quinine.

Reference: The Use of Antimalarial Drugs: Report of WHO Informal Consultation 13th-17th Nov, 2000.

VIII.PREVENTION:
Prevention is based on avoiding exposure to mosquitoes and aggressively treating people who are infected. Malaria control programs in many parts of the world are underfunded and ineffective. If you are to an area where malaria is common, take anti malarial drugs exactly as prescribed by your physician and prevent mosquito bites by
*  Closing windows at night if possible.
*  Sleeping with a mosquito net, preferably one containing an insecticide, with the edges tucked under the mattress.
*  Covering up your body as much as possible with clothing.
*  Applying an insect repellent to areas of the body not covered by clothing.

IX.CONCLUSION:
This review gives a brief conclusion about disease prevalence, already discovered drugs. It further helps to carry out further research in prevention and eradication of malaria.

X.REFERENCES:
1.    MALARIA: A Major Killer Disease in India; PhaRmeD TRADE NEWS; SEPTEMBER, 2006.
2.    CLINICAL PHARMACOLOGY by D.R.Laurence,P.N.Bennet, M.J.Brown; eighth edition.
3.    Clinical presentations of severe and complicated malaria in India by SK.Mishra, S. Mohanty; Journal, Indian Academy of Clinical Medicine Vol.2, No.3 July September.
4.    Integrated management of childhood illness; Reference library of Selected Materials, WHO, Department of Child and Adolescent Health and Development: Unicef.
5.    Basic and clinicaql pharmacology by Betram G.Katzung, Seventh edition, page.838.
6.    The Use of Antimalarial Drugs: Report of WHO Informal Consultation 13th-17th Nov, 2000.
7.    health scout.com/ ency/ 68/347/ main.htm/
8.    malariasite.com/malaria/Evolution.htm
9.    malariasite.com/malaria/Diagnosis of malaria.htm
10.   malariasite.com/malaria/Life of plasmodium.htm

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