8.1.3 Supportive treatment of uncomplicated malaria cases
Many malaria patients have other clinical problems associated with malaria infection. While most of these problems get resolved when the patients are treated for malaria, some conditions need treatment at the same time as the malaria, that is, supportive treatment. Some of the supportive treatments that you should give the patient are as follows:
- If high fever is present, give the patient paracetamol tablets. Also advise the patient or caregivers to cool the fever by wetting the body of the patient with clean pieces of cloth dipped in slightly warm water, or by fanning.
- For patients with moderate dehydration, give oral rehydration salts (ORS) and advise them to drink more clean water or other fluids. In the case of breastfed infants, encourage mothers to provide extra breastfeeding.
- If you suspect mild or moderate anaemia is present, give ferrous sulphate (iron tablets), 200 mg once daily for two months, and advise the patient to return for a recheck in two months.
In addition to the diagnosis and treatment services you give to the patient with uncomplicated malaria, advise or educate the patient or the caregiver on the following issues and tell him or her that:
- He or she has a malaria infection.
- Early treatment within 24 hours of fever onset is important to prevent severe illness and death.
- To take/give the patient enough food, if possible a fatty meal, prior to taking the drug (Figure 8.5).
- To complete the full dose of treatment of the drug given, for example six doses of treatment for three days for Coartem.
- To return to the Health Post if the fever does not stop or if the patient does not get well after three days. The patient should also return to the Health Post if at any time before three days the condition gets worse — for example if the patient is unable to avoid vomiting up the drug, or there is persistent vomiting, dehydration, confusion, or excessive sleepiness.
8.1.2 Treatment of uncomplicated malaria based on clinical diagnosis
8.2 Pre-referral treatment of severe malaria at the Health Post level