National Drug Policy – Malaria Control

1.First line of treatment - use of Chloroquine
Second line of treatment - ACT-SP combination.

2.The Presumptive Treatment is to be replaced by treatment of clinical malaria.
(Clinical Malaria – patient showing signs and symptoms of malaria without any other obvious causes.)
2.1 In low risk area – full therapeutic dose of Chloroquine (25 mg/Kg bw over a period of 3 days – 1500 mg.)
2.2 In High Risk Area - full therapeutic dose of Chloroquine as above + Primaquine 0.75 mg/Kg bw on first day – 45 mg.)

3. Radical Treatment to positive cases by RDK & Microscopically.
3.1 RT for Pf cases – Chloroquine 25 mg/Kg bw over a period of 3 days(1500 mg)+Primaquine 0.75 mg/Kg bw on first day (45 mg.)
3.2 RT for Pv Cases – Chloroquine 25 mg/Kg bw over a period of 3 days (1500 mg) + Primaquine 0.25 mg/Kg bw daily for 14 days ( 15 mg/day.)

4.In Chloroquine resistant area – where treatment failure is more than 10% cases, the second line of treatment should be followed.
Sulphadoxin – 25 mg. / Kg. bw + Pyrimethamine 1.25 mg / Kg.bwt. On first day with Artesunate 4 mg./Kg.bw. On 1st, 2nd & 3rd day.
(Treatment failure :- patient not responding for first line of treatment. The Clinician should ensure that patient has consumed all drugs for 3 days in his presence.)

5.Change of second line of treatment may be implemented in a cluster of PHCs around the resistant foci, after taking into consideration the epidemiological trend of Pf (Pf >30%) with approval of Director NVBDCP

6.Primaquine is contraindicated in pregnancy and infants

7.Chemoprophylaxis
7.1 In Chloroquine sensitive area :- Loading dose of Chloroquine 10 mg /Kg. bw followed by 5 mg./Kg.bw weekly till one month after delivery or return from endemic area.
7.2 In Chloroquine resistant areas - Chloroquine – as above + Proguanil 200 mg daily.