Treatment protocol

Who will be treated?

• People will be treated based only on the results of diagnostic tests performed, not on any other clinical assessment

• Who will be treated?– Children with severe anaemia

(<8 g/dl haemoglobin)– Anyone with positive RDT for malaria

Decision rules

• Things to consider– Is haemoglobin <8 g?– Is the RDT positive?– Is the woman pregnant?– What is the person’s age?– Is child 2 years or older?

Anemia

• Is Hb <7g/dl in child under 6 years?– If yes, treat with

• 1) CoArtem • 2) Iron• 3) Mebendazole (if 2 years or older)

– If no, do not give iron and albendazole.CoArtem depends on RDT results

– Also refer to health facility based on clinical judgment

Anaemia treatment

1. Albendazole or Mebendazole: For children age 2 years and over: Tablet or syrup

2. Iron tablets or syrup:

Malaria and anaemia

• RDT Pf + (simple malaria) and mild anaemia (Hb between 8-11.5 g/dl) – treated with Coartem® – given a 2 weeks course of folic acid

Malaria parasite testing

• RDTs– Children (>5kg) with positive RDT results clinically not

fitting into the severe malaria classification (severe aneamia, prostration, impaired consciousness, respiratory distress, convulsions, circulatory collapse, abnormal bleeding, jaundice and passing black/brown[dark] urine) :

• Will immediately receive Coartem®• Children treated within the past 2 weeks with Coartem® will

be referred to a facility for further evaluation– Children (<5kg) with positive RDT results:

• Will immediately receive SP• Panadol

Malaria Treatment

Number of tablets per dose Weight (kg)

Age (Years)

Twice daily for 3 days

Day 1 Day 2 Day 3

Morning

Evening

Morning Evening

Morning Evening

5 – 14 3 m – 2 yrs 1 1 1 1 1 1

15 – 24 3 – 7 yrs 2 2 2 2 2 2

25 – 34 8 – 10 yrs 3 3 3 3 3 3

35+ >10 yrs 4 4 4 4 4 4

1.CoArtem: Tablets with 20 mg Artemether plus 120 mg Lumefantrine

Severe malaria

• Children clinically assessed by the survey nurse to have severe malaria will be transported immediately to the nearest health centre

What about other sick people?

• You will be approached by others in the village.• Do not use RDT for non-participants in other

households• Explain that you are there mainly for the survey

and your supplies have been calculated accordingly

• Give presumptive treatment according to clinical judgment

• Refer or transport to health facility if necessary