Treatment

Each year, an estimated 600 000 people die from malaria – a treatable disease. Effective case management requires both early diagnosis and prompt treatment. The best available treatment, particularly for Plasmodium falciparum malaria, is artemisinin-based combination therapy (ACT).

The primary objective of treatment is curing the infection by ensuring the rapid and full elimination of Plasmodium parasites from a patient’s bloodstream. This also prevent an uncomplicated case of malaria from progressing to severe disease or death. From a public health perspective, effective treatment also minimizes transmission of the infection to others by reducing the infectious reservoir and by preventing the emergence and spread of resistance to antimalarial medicines.

Patients with suspected malaria should have parasitological confirmation of diagnosis with either microscopy or rapid diagnostic test (RDT) before antimalarial treatment is started. Treatment based on clinical grounds should only be given if diagnostic testing is not immediately accessible within 2 hours of patients presenting for treatment. Prompt treatment – within 24 hours of fever onset – with effective and safe antimalarial is necessary to effect a cure and prevent life-threatening complications.

ACTs combine 2 active pharmaceuticals with different mechanisms of action: an artemisinin derivative extracted from Artemisia annua and a partner drug. WHO does not support the promotion or use of Artemisia plant material (such as teas, tablets, or capsules) for malaria prevention or treatment. 

Use of oral artemisinin-based monotherapy is considered a contributing factor to the development and spread of resistance to artemisinins.  WHO has urged malaria-endemic countries to take measures to halt their production and marketing, and to promote access to quality-assured ACTs for the treatment of falciparum malaria.