Manejo clínico-terapéutico de la malaria grave

Malaria - Transmission, Diagnosis and Treatment

“…For this clinical form, artemisinin combinations (ACTs) are available, with duration of 3 days and covering two asexual cycles. In relation to the doses, they must be optimal to guarantee rapid clinical and parasitological cure, decrease transmission, and avoid drug resistance [2,4,6].…”

“…Severe malaria is a medical emergency, and it is essential to perform supportive measures and give full and effective parenteral or rectal doses of antimalarial drugs in the initial treatment. Two groups of drugs are available for intravenous administration: artemisinin derivatives (artesunate or artemether) and cinchona alkaloids (quinine and quinidine) [2,4,6,32,33].…”

“…Hydration: If there is no evidence of fluid overload, patients with oral intolerance (adults and pediatric) should receive 5% dextrose solutions, and those who tolerate the oral route, administer isotonic saline solution at a rate of 1-2 mL/kg/hour. Take care not to overhydrate the patient [2,6].…”

“…Treatment of anemia: In adults, if the hematocrit <20 or Hb < 7 g/dL, transfuse whole blood or packed red cells over 6 hours [2,6].…”

“…Of all these, P. falciparum infection is the most severe and causes several clinical conditions of organ damage, called complicated malaria; it can be fatal, if not treated in time [4,6].…”