Chloroquine resistant-PF Chloroquine sensitive-PF Malaria Endemic Areas Mexico, Central America west of Panama canal, Carribean, South America, middle east Resistant PV Indonesia,Papua New Guinea, Burma
Short acting high efficacy drug to quickly kill 95% of parasites
Long acting drug for 7 days[Small parasite load, reduced chances of selecting mutants
ACT is the choice. Why?
Rapid clinical, parasitological cure
No resistance(Combination prevents)
Combination regimens: Ref.KDT 6 th Ed.
Chemoprophylaxis Type Drug Before Entering After Leaving Chloroquine Sensitive Chloroquine po 4 500mg once a week 1-2weeks 4 weeks Resistant strains Pro+Ato(Malarone) 1tab/d 1-2 days 7 days Mefloquine 250mg/week 1-2 weeks 4 weeks Doxycycline 100mg 1Tab o.d. 1 day before 4 weeks