Diagnosis, Treatment and Prevention of Malaria in Travellers - Related Resources

Cochrane reviews

• SPf66 vaccine may provide a modest (about 25%) protection from Plasmodium falciparum malaria, but benefit has been only observed in trials outside Africa Vaccines for Preventing Malaria.
• High first dose quinine regimen appears to reduce fever clearance time and parasite clearance in severe malaria High First Dose Quinine Regimen for Treating Severe Malaria.
• Artesunate (10 mg) plus mefloquine (25 mg/kg) performs better than mefloquine alone for treating uncomplicated falciparum malaria in areas with low malaria transmission Artesunate Plus Mefloquine Versus Mefloquine for Treating Uncomplicated Malaria.
• Sulfadoxine-pyrimethamine plus amodiaquine appears to perform better than sulfadoxine-pyrimethamine plus artesunate when treating uncomplicated malaria. Local resistance patterns have to be carefully considered Sulfadoxine-Pyrimethamine Plus Artesunate Versus Sulfadoxine-Pyrimethamine Plus Amodiaquine for Treating Uncomplicated Malaria.
• Prophylaxis and intermittent treatment with antimalarial drugs reduce clinical malaria and severe anaemia in preschool children. There is insufficient evidence to detect an effect on mortality Intermittent Preventive Treatment for Malaria in Children.
• Drugs given routinely for malaria during pregnancy for low parity women reduce severe antenatal anaemia in the mother, increase birthweight and may reduce perinatal deaths Drugs for Preventing Malaria-Related Illness in Pregnant Women and Death in the Newborn.
• Routine phenobarbitone in cerebral malaria appears to cause more deaths compared with placebo, although it is effective for convulsions Routine Anticonvulsants for Treating Cerebral Malaria.
• Electronic mosquito repellents appear not to be effective in preventing mosquito bites and malaria infection Electronic Mosquito Repellents for Preventing Mosquito Bites and Malaria Infection.
• The evidence on malaria treatment options in pregnancy is insufficient for conclusions. Some combination treatments appear to be effective at treating malaria in pregnancy; however, safety data are limited Drugs for Malaria in Pregnant Women.
• Arteether seems not to be any worse than quinine for treating severe malaria in children, although the evidence is insufficient Intramuscular Arteether for Treating Severe Malaria.
• Steroids as an adjunct to antimalarial treatment may not reduce mortality in cerebral malaria compared to antimalarial treatment alone, and appear to increase gastrointestinal bleeding and seizures Steroids for Treating Cerebral Malaria.
• Artemisinin-based combination therapies (ACTs) appear to be highly effective for treating uncomplicated malaria. Dihydroartemisinin-piperaquine appears to be another effective first-line treatment for P. falciparum malaria Artemisinin-Based Combination Therapy for Treating Uncomplicated Malaria.

Other evidence summaries

• Addition of 3 days' artesunate to standard antimalarial treatments substantially reduces treatment failure, recrudescence and gametocyte carriage .

Other Internet resources

• WHO malaria site http://www.who.int/topics/malaria/en/
• Centers for Disease Control and Prevention, USA. Treatment of Malaria: Guidelines For Clinicians (United States) Part 3: Alternatives for Pregnant Women and Treatment of Severe Malaria http://www.cdc.gov/malaria/diagnosis_treatment/clinicians3.html

Literature