Malaria is a prevalent cause of febrile illnesses in areas with high transmission, and its clinical presentation overlaps with initial signs of Ebola disease. For this reason, the effectiveness of the Ebola response in Guinea, Liberia and Sierra Leone can be optimized through the deployment of targe...ted measures to reduce the number of fever cases due to malaria
WHO recommends specific adaptations in the diagnosis of malaria and in LLIN distribution in countries heavily affected by the Ebola outbreak and mass drug administration using artemisinin-based combination therapies (ACTs) in areas where transmission of both Ebola and malaria is high and access to malaria treatment is very low.
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The article "Malaria – MSD Manual Professional Edition" provides a comprehensive overview of malaria, an infection caused by Plasmodium species. It describes symptoms such as fever, chills, and anemia, explains diagnostic methods like parasite detection in blood smears, and discusses treatment opt...ions including artemisinin-based combination therapies. In addition, it outlines prevention strategies such as medical prophylaxis and mosquito control measures. The article is intended for medical professionals and offers detailed information on the pathophysiology, clinical presentation, and management of malaria.
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The MSF malaria guidelines provide practical, evidence-based recommendations for diagnosing, treating, and preventing malaria, especially in low-resource settings. They cover uncomplicated and severe cases, recommend rapid tests and artemisinin-based therapies, and include special guidance for vulne...rable groups like children and pregnant women.
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In November 2022, WHO launched a strategy to address antimalarial drug resistance in Africa, emphasizing the need for stronger surveillance. While regional monitoring networks have been active in other regions, most in Africa have not convened since 2017–2018. To renew collaboration, WHO organized... a meeting bringing together countries from the African and Eastern Mediterranean regions. Participants shared recent data on antimalarial efficacy and resistance. While artemisinin-based combination therapies remain highly effective, some sites in Uganda and the United Republic of Tanzania reported lower-than-expected efficacy of artemether–lumefantrine. Delayed parasite clearance linked to Plasmodium falciparum Kelch-13 mutations was noted in Eritrea, Rwanda, Uganda and the United Republic of Tanzania. Discussions highlighted challenges in therapeutic efficacy studies, molecular marker surveillance and the need for improved genotyping to distinguish relapses from new infections.
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Antimalarial chemotherapy is crucial for reducing morbidity, mortality, and drug resistance, and is the cornerstone of malaria control. Existing antimalarial drugs act at different stages of the parasite’s life cycle. These drugs range from classic agents such as chloroquine and quinine to newer a...rtemisinin derivatives. They include tissue schizonticides, blood schizonticides, gametocytocides, and sporontocides. Artemisinin and its derivatives are the most effective and fastest-acting treatment against drug-resistant Plasmodium falciparum, achieving rapid parasite clearance and reducing transmission potential. Other key drugs include mefloquine, halofantrine, proguanil, sulfadoxine–pyrimethamine, atovaquone–proguanil, tetracyclines, clindamycin and azithromycin. Each of these drugs has a specific mechanism of action, pharmacokinetics, efficacy, safety profile and contraindications. Rational drug combinations and adherence to national treatment guidelines are essential for managing resistance, ensuring safety in vulnerable populations such as children and pregnant women, and optimising therapeutic outcomes in cases of both uncomplicated and severe malaria.
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Combination therapy is a cornerstone of modern malaria treatment, particularly in the context of widespread multidrug resistance. Using two or more antimalarial drugs with different mechanisms simultaneously enhances efficacy, shortens treatment duration, improves compliance and delays the developme...nt of resistance. Artemisinin-based combination therapies (ACTs), such as artemether–lumefantrine, artesunate–amodiaquine and artesunate–sulfadoxine/pyrimethamine, are highly effective in rapidly clearing parasites and reducing gametocyte carriage. They are also generally well tolerated. Non-artemisinin combinations, quinine-based regimens and novel combinations (e.g. piperaquine–dihydroartemisinin) offer alternative therapeutic options, although clinical experience with these remains limited. Although ACTs are the preferred first-line treatment, factors such as cost, local drug resistance patterns, safety during pregnancy and paediatric use must inform implementation and policy decisions.
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Malaria remains a significant public health concern in the SADC region, accounting for 20% of childhood deaths, as well as prompting numerous outpatient visits and hospitalisations. Around three-quarters of the population, including 35 million children under the age of five and 8.5 million pregnant ...women, are at risk. Transmission patterns vary from high and stable in the north to malaria-free in the south, with low, unstable and seasonal zones in between. Although interventions such as indoor residual spraying (IRS), insecticide-treated nets (ITNs/LLINs), intermittent preventive treatment in pregnancy (IPTp), rapid diagnostic tests (RDTs), and artemisinin-based combination therapies (ACTs) have reduced the malaria burden, challenges persist in terms of funding, human resources, surveillance, and cross-border coordination. Achieving malaria elimination in the SADC region requires harmonised regional standards, strengthened surveillance, and improved access to quality treatment and policy prioritisation.
Accessed on 27/08/2025.
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La Stratégie de riposte face à la résistance aux antipaludiques en Afrique est un document technique de sensibilisation qui se fonde sur les bases factuelles les plus solides dont on dispose et vise à réduire au maximum la menace et l’impact de la résistance aux antipaludiques de Plasmodium ...falciparum en Afrique. Elle a pour objectifs i) d’améliorer la détection de la résistance et d’assurer une riposte en temps utile ; ii) de retarder l’émergence de la résistance à l’artémisinine et aux médicaments associés utilisés dans les combinaisons thérapeutiques à base d’artémisinine (CTA) ; et iii) de freiner la sélection et la propagation des parasites résistants là où une pharmacorésistance est confirmée. Si la Stratégie cible l’Afrique, il convient de noter que la
menace de la résistance aux antipaludiques concerne tous les pays d’endémie palustre et que les interventions proposées dans le présent document sont applicables dans d’autres régions géographiques à condition d’être adaptées aux spécificités locales.
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Les manuels de formation TACT et la brochure destinée aux patients ont été élaborés dans le cadre de l'initiative du consortium ACT visant à améliorer la prise en charge du paludisme en encourageant l'utilisation correcte des tests de diagnostic rapide (TDR). L'initiative TACT (Targeting ACTs...) vise à garantir l'utilisation appropriée des combinaisons thérapeutiques à base d'artémisinine (ACT), en ne traitant que les cas de paludisme confirmés et en orientant les patients vers d'autres traitements pour les maladies fébriles non liées au paludisme. Les manuels proposent une formation interactive sur le lieu de travail pour aider les personnels de santé à passer d'un traitement présomptif à un diagnostic fondé sur des tests, conformément à la politique de l'OMS. La brochure d'accompagnement destinée aux patients, disponible en anglais et en swahili, s'appuie sur des récits illustrés pour expliquer l'utilité et le fonctionnement des TDR, répondre aux inquiétudes les plus courantes et encourager la confiance dans les résultats des tests. Ces documents, dont la clarté et la compréhension ont été testées au préalable, permettent d'opérer des changements durables dans la pratique clinique et la communication avec les patients au sein des établissements de soins primaires tanzaniens.
Accessed on 03/07/2025.
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Ce document présente les lignes directrices actualisées pour la prise en charge du paludisme en République Centrafricaine. Il s’appuie sur les recommandations de l’OMS et vise à améliorer le diagnostic, le traitement et la prévention de la maladie, particulièrement chez les femmes enceint...es et les enfants de moins de cinq ans. Il insiste sur l’utilisation des tests de diagnostic rapide (TDR) et des combinaisons thérapeutiques à base d’artémisinine (CTA). Il définit aussi les traitements selon la gravité du paludisme et la condition du patient, et propose une approche préventive à travers le traitement préventif intermittent (TPI) chez les femmes enceintes et les nourrissons. Le document détaille également le rôle des agents de santé et des relais communautaires dans la stratégie nationale de lutte contre le paludisme.
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Malaria and HIV, two of the world’s most deadly diseases, are widespread, but their distribution overlaps greatly in sub-Saharan Africa. Consequently, malaria and HIV coinfection (MHC) is common in the region. In this paper, pertinent publications on the prevalence, impact, and treatment strategie...s of MHC obtained by searching major electronic databases (PubMed, PubMed Central, Google Scholar, ScienceDirect, and Scopus) were reviewed, and it was found that the prevalence of MHC in SSA was 0.7%–47.5% overall. Prevalence was 0.7%–47.5% in nonpregnant adults, 1.2%–27.8% in children, and 0.94%–37% in pregnant women. MHC was associated with an increased frequency of clinical parasitemia and severe malaria, increased parasite and viral load, and impaired immunity to malaria in nonpregnant adults, children, and pregnant women, increased in placental malaria and related outcomes in pregnant women, and impaired antimalarial drug efficacy in nonpregnant adults and pregnant women. Although a few cases of adverse events have been reported in coinfected patients receiving antimalarial and antiretroviral drugs concurrently, available data are very limited and have not prompted major revision in treatment guidelines for both diseases. Artemisinin-based combination therapy and cotrimoxazole are currently the recommended drugs for treatment and prevention of malaria in HIV-infected children and adults. However, concurrent administration of cotrimoxazole and sulfadoxine–pyrimethamine in HIV-infected pregnant women is not recommended, because of high risk of sulfonamide toxicity. Further research is needed to enhance our understanding of the impact of malaria on HIV, drug–drug interactions in patients receiving antimalarials and antiretroviral drugs concomitantly, and the development of newer, safer, and more cost-effective drugs and vaccines to prevent malaria in HIV-infected pregnant women.
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Update, 2023. En 2021, les résultats préliminaires des études d’observation du projet CARAMAL (Community Access to Rectal Artesunate for Malaria) n’ont pas confirmé l’impact sur la mortalité observé dans l’essai contrôlé de 2009. Par conséquent, en janvier 2022, l’OMS a publié un...e note d’information sur l’artésunate rectal, dans laquelle elle suggérait des mesures immédiates d’atténuation des risques.
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Information note. In 2021, preliminary results of observational studies from the Community Access to Rectal Artesunate for Malaria (CARAMAL) project did not confirm the mortality impact observed in the controlled trial in 2009. Consequently, in January 2022, WHO released an information note on recta...l artesunate (RAS), suggesting immediate risk mitigation measures. To provide clarity on the evidence, WHO subsequently convened independent experts to conduct a formal evidence review of the data from the CARAMAL project, as well as data from other studies evaluating the deployment of pre-referral RAS at programmatic level
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Actualización de 2023. Nota informativa. En 2021, los resultados preliminares de los estudios observacionales del proyecto de Acceso Comunitario al Artesunato Rectal para el Paludismo (CARAMAL, por sus siglas en inglés) no confirmaron el impacto en la mortalidad observado en el ensayo controlado d...e 2009. En consecuencia, la OMS publicó una nota informativa sobre el artesunato rectal en la que se sugerían medidas inmediatas de reducción del riesgo.
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This infographic poster provides key information on the prevention, transmission and control of malaria in Southeast Asia. It highlights regional challenges, the behaviour of malaria vectors, and community-based strategies to build resilience against the disease. Designed for public health workers a...nd communities, its purpose is to raise awareness and promote effective malaria interventions that will reduce the disease's burden on the region. Accessed June 2025
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This implementation plan sets out a series of programmatic objectives, activities and outcomes for malaria surveillance strengthening in Myanmar over the next two years. This period represents a key phase as the National Malaria Control Programme (NMCP) strives to build on recent achievements in str...engthening core surveillance operations.
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Accessed on 30.01.2020
Au Sénégal, la mortalité infanto-juvénile est surtout causée par le paludisme les maladies diarrhéiques et les infections respiratoires aigües (IRA). Des travaux ont montré que 80% des décès d’enfants de zéro à cinq ans (0 à 5 ans) surviennent dans les maisons ...sans aucun contact avec les services de santé. D’où la nécessité de mettre en place des interventions à base communautaire efficaces pour réduire cette mortalité. A ce propos, la problématique de la consolidation et de l’élargissement des interventions à base communautaire se pose avec beaucoup d’acuité.
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Le présent document est un manuel destiné au Dispensateur de Soins à Domicile (DSDOM) exerçant dans un site PECADOM. Il a pour objet de l’aider à prendre en charge de façon précoce et adéquate le paludisme, la diarrhée et les infections respiratoires aigües.
Les informations et les ...images contenues dans le manuel aideront le DSDOM d’une part à se familiariser avec les différentes pathologies décrites pour un diagnostic et un traitement adéquats et d’autre part à connaitre les messages clés à véhiculer sur la prise en charge et la prévention du paludisme, des IRA et de la diarrhée au niveau communautaire.
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