8.3 Management of malaria in special groups
Special population groups such as infants below the age of four months or below 5 kg weight, and pregnant mothers in the first trimester, need different treatment and special attention.
What is the drug you give to treat malaria for an infant less than 5 kg body weight?
You give quinine oral tablets three times a day for 7 days, with the dose as indicated in Table 8.3 earlier in this study session.
Now we will tell you about pregnant women. Pregnant women are at high risk of developing severe malaria. In addition, malaria during pregnancy can cause premature labour, stillbirth or abortion, as well as severe anaemia in the mother. The baby that is born may have low birth weight.
Therefore, you must give effective anti-malaria treatment to pregnant women with malaria immediately.
Pregnant women in the first trimester (the first three months) of pregnancy should NOT take Coartem. During the first trimester give oral quinine three times a day for 7 days (for dosage see Table 8.3 above). However, you can give Coartem if there is no quinine, or if you strongly believe that the mother may not comply with the seven days of quinine treatment. The first dose should be given under your direct supervision.
If vomiting occurs within 30 minutes after swallowing the drug, the dose should be repeated with a replacement dose to ensure completion of treatment.
Advise the patient to take food while taking the drug, as quinine might cause low blood sugar (hypoglycaemia). Also assure her that symptoms like dizziness, ringing in the ears, blurred vision and tremors might occur, but these are not severe enough to stop treatment, and they will end when the drug treatment is finished. Explain to her the importance of completing her malaria treatment for the health of her unborn baby.