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PAPERBACK + PDF your price: $43.50 add to cart PAPERBACK list:$37.00 Web:$33.30 add to cart PDF BOOK your price: $28.50 add to cart PDF CHAPTERS your price: $2.50 select Rights & Permissions Free Resources PDF EXECUTIVE SUMMARY Display this book on your site! Related Titles Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Scaling Up Treatment for the Global AIDS Pandemic: Challenges and Opportunities Other Related Titles Malaria Control During Mass Population Movements and Natural Disasters (2002) Committee on Population (CPOP) Web Search Builder Use this book's key terms to search within this book, across our collection, or across the Web. Skim This Chapter Skim this chapter and use this chapter's key terms to search within this book. Reference Finder Paste in your own text to find books that relate to your topic. Page 155   E-mail  Facebook  Digg  Stumble  Twitter More The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. APPENDIX C Alternative Treatment Regimens for Severe Malaria The recommended treatment regimen for management of severe malaria given in Chapter 6 assumes that a fairly high level of patient care is possible (i.e., availability of intravenous therapy). There are clearly situations where this would not be the case. The following regimens allow for treatment of severe malaria in settings where such capacity is not available (World Health Organization, 2000a, 2000b). Note: The use of suppositories containing an artemisinin drug is based on limited clinical experience but is the subject of ongoing clinical trials. INTRAMUSCULAR QUININE Loading Dose Quinine dihydrochloride is given intramuscularly at 20 mg salt/kg diluted to 60 mg/ml in normal saline. The dose should be split between two injection sites in the anterior thigh (not the buttocks). Maintenance Dose Eight hours after the loading dose, quinine dihydrochloride is given intramuscularly at 10 mg salt/kg and repeated every 8 hours until the patient can take oral medication. Oral medication should follow the regimen described in Chapter 6. Page 155 Front Matter (R1-R16) 1. Introduction (1-7) 2. Malaria and Mobility -- A Brief History and Overview (8-23) 3. Epidemiology of Malaria (24-51) 4. Essential Components/Design of an Optimal Malaria Control Program (52-52) 5. Public Health Surveillance System (53-56) 6. Curative Services: Malaria Therapy and Case Management (57-79) 7. Preventive Interventions (80-92) 8. Community Involvement in Malaria Control and Prevention (93-102) 9. Special Studies and Operational Research (103-108) 10. Prophylaxis and Personal Protection for Relief Workers (109-112) 11. Return, Repatriation, or Resettlement of Displaced Populations (113-116) 12. Improving Malaria Control in Complex Emergencies (117-119) References (120-144) Appendix A: Description of Antimalarial Drugs (145-150) Appendix B: Methodology for Efficacy Assessment of In Vivo Malaria Therapy (151-154) Appendix C: Alternative Treatment Regimens for Severe Malaria (155-156) Appendix D: Malaria Research and Technical Resources (157-161) Appendix E: About the Authors (162-164)

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OCR for page 155
Malaria Control During Mass Population Movements and Natural Disasters APPENDIX C Alternative Treatment Regimens for Severe Malaria The recommended treatment regimen for management of severe malaria given in Chapter 6 assumes that a fairly high level of patient care is possible (i.e., availability of intravenous therapy). There are clearly situations where this would not be the case. The following regimens allow for treatment of severe malaria in settings where such capacity is not available (World Health Organization, 2000a, 2000b). Note: The use of suppositories containing an artemisinin drug is based on limited clinical experience but is the subject of ongoing clinical trials. INTRAMUSCULAR QUININE Loading Dose Quinine dihydrochloride is given intramuscularly at 20 mg salt/kg diluted to 60 mg/ml in normal saline. The dose should be split between two injection sites in the anterior thigh (not the buttocks). Maintenance Dose Eight hours after the loading dose, quinine dihydrochloride is given intramuscularly at 10 mg salt/kg and repeated every 8 hours until the patient can take oral medication. Oral medication should follow the regimen described in Chapter 6.

OCR for page 156
Malaria Control During Mass Population Movements and Natural Disasters INTRAMUSCULAR ARTEMISININ DRUGS Artesunate can be given intramuscularly at 2.4 mg/kg initially, followed by 1.2 mg/kg 12 hours and 24 hours later, then 1.2 mg/kg daily for 6 days. An oral artemisinin compound can be used once the patient can take oral medication. Alternatively, after a minimum of 3 days of artesunate, patients able to take oral medications can be switched to another antimalarial drug appropriate to the area (e.g., either sulfadoxine/pyrimethamine or mefloquine in areas where those drugs remain effective). Artemether can be given intramuscularly at 3.2 mg/kg on the first day, followed by 1.6 mg/kg daily for 6 days. An oral artemisinin compound can be used once the patient can take oral medication. Alternatively, after a minimum of 3 days of artesunate, patients able to take oral medications can be switched to another antimalarial drug appropriate to the area (e.g., either sulfadoxine/pyrimethamine or mefloquine in areas where those drugs remain effective). INTRARECTAL ARTEMISININ DRUGS Artemisinin suppositories can be given using a 40 mg/kg loading dose, followed by 20 mg/kg at 4, 24, 48, and 72 hours. Patients able to take oral medications can then be switched to an oral artemisinin drug at an appropriate dose or another antimalarial drug appropriate to the area (e.g., either sulfadoxine/pyrimethamine or mefloquine in areas where those drugs remain effective). Artesunate suppositories can be given using one 200-mg suppository initially, followed by one 200-mg suppository at 12, 24, 36, 48, and 60 hours. Patients able to take oral medications can then be switched to an oral artemisinin drug at an appropriate dose or another antimalarial drug appropriate to the area (e.g., either sulfadoxine/pyrimethamine or mefloquine in areas where those drugs remain effective). For additional details and recommendations, refer to World Health Organization (2000a, 2000b).

Representative terms from entire chapter:

oral artemisinin