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1
The WHO recommends parenteral artesunate over quinine and artemether for treating severe Plasmodium falciparum malaria in adults and children. Intravenous administration is preferred. A new one-step
...
, arginine-based formulation eliminates the need for dilution steps, reducing errors and accelerating the initiation of treatment—a critical factor for survival. This formulation was first prequalified by the WHO in 2023. By contrast, the conventional two-step artesunate formulation, which was prequalified in 2010, requires more complex preparation. Clear guidance is essential, as product-specific protocols differ. These training materials aim to support the correct and effective administration of the medication.
Accessed on 27/06/2025.
more
The Severe Malaria Observatory (SMO) is a global knowledge platform designed to enable professionals working on severe
...
malaria, such as researchers, clinicians, public health experts, programme managers, policymakers and technical partners, to access, share and analyse reliable data on malaria complications.
more
BMC Medicine (2015) 13:42 DOI 10.1186/s12916-014-0263-6
District hospital level Severe | Malaria is a Medical Emergency
The MalariaCare Toolkit. Tools for maintaining high-quality malaria
case management services.
Developed by MalariaCare, this module supports health supervisors in improving the management of severe
...
malaria by providing focused, case-based learning and mentorship. It provides clinical supervisors with the necessary tools to guide healthcare providers during outreach training and supportive supervision (OTSS) visits. The module is designed to strengthen diagnostic and treatment skills, particularly in areas that are often overlooked, such as severe malaria. It uses real-life case studies and guided discussions to assess and enhance clinical understanding. Its flexible structure can be adapted based on the knowledge level of the provider, promoting effective, practical learning in healthcare settings.
Accessed on 03/07/2025.
more
hese are two parallel guidelines, one for small hospitals and another one for large hospitals. In view of heavy burden of malaria and prevalence of drug resistant falciparum malaria in the South-Eas
...
t Asia Region, the guidelines were developed for use by medical personnel who treat severe malaria patients, referred from lower-level health facilities. The guidelines were developed by the WHO Regional Office for South-East Asia and the WHO Collaborating Centre for the Clinical Management of Malaria, Faculty of Tropical Medicine, Mahidol University, Thailand. The guidelines are based on a review of current evidence, existing WHO guidelines and experience in the management of malaria in the Region
more
Regional Guidelines for the Management of Severe Falciparum Malaria in Small Hospitals
Polrat Wilairatana, Srivicha Krudsood, Ma. Sandra B. Tempongko et al.
WHO South-East Asia New Delhi
(2006)
C1
These are two parallel guidelines, one for small hospitals and another one for large hospitals. In view of heavy burden of malaria and prevalence of drug resistant falciparum malaria in the South-Ea
...
st Asia Region, the guidelines were developed for use by medical personnel who treat severe malaria patients, referred from lower-level health facilities. The guidelines were developed by the WHO Regional Office for South-East Asia and the WHO Collaborating Centre for the Clinical Management of Malaria, Faculty of Tropical Medicine, Mahidol University, Thailand. The guidelines are based on a review of current evidence, existing WHO guidelines and experience in the management of malaria in the Region.
more
The document titled "Checklist for Assessing Management of Severe Malaria" is part of the MalariaCare Toolkit. It provides a structured tool for supervisors conducting outreach training and supporti
...
ve supervision (OTSS) visits in healthcare facilities. The checklist is designed to evaluate and guide the clinical management of severe malaria cases, including diagnostics, treatment planning, complication management, patient monitoring, and the administration of injectable artesunate. It also includes sections for direct observation of clinical procedures and supervisor feedback to help improve healthcare worker performance and adherence to national treatment guidelines.
more
Prompt, effective antimalarial treatment, and supportive care can substantially reduce the rate of mortality from severe malaria. However, many children in
...
malaria-endemic countries do not have access to health facilities or a qualified health care provider and do not receive the necessary care in a timely fashion. Without rapid detection of danger signs and access to effective treatment, including pre-referral treatment that can be administered in the community level, many of these children with severe malaria die.
In situations where there is no immediate access to a health care facility, WHO recommends the administration of a standard dose of an effective antimalarial medicine as pre-referral treatment before referral to a facility at which complete treatment can be administered.
Rectal artesunate is the WHO-recommended pre-referral intervention in situations where artesunate injection are not feasible for children under the age of 6 years with suspected severe malaria. The intervention reduces the risk of death or permanent disability by up to 50% provided the child is referred to a health facility at which complete treatment can be administered.
This field guide is aimed at supporting the effective deployment of RAS as pre-referral treatment of suspected severe malaria in line with the WHO malaria guidelines.
more
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 Janu
...
ary 2022, WHO released an information note on rectal 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
more
Since December 2010, Malaria Consortium has been implementing an innovative approach to community management of severe acute malnutrition, together with an existing integrated community case managem
...
ent (ICCM) programme in South Sudan. This learning paper considers Malaria Consortiums experience of this combined approach in a highly complex context and shows whether the management of severe acute malnutrition is an effective, acceptable and feasible component of ICCM programming
more
The Rectal Artesunate Tools & Training package has been developed to support the safe and effective use of artesunate rectal capsules (ARCs) as a pre-referral treatment for severe malaria, in line w
...
ith WHO guidelines. Primarily aimed at community health workers operating in remote areas, the package provides step-by-step visual and written guidance on ARC administration. The training resources were field-tested in Malawi and Senegal, and refined based on user feedback to ensure clarity, usability and cultural appropriateness. The toolkit includes user guides and job aids in English, French and Portuguese, and was created in collaboration with MMV, the WHO, Save the Children, the IFRC, MSF and the Malaria Consortium. These tools form part of broader efforts to integrate ARC into national malaria strategies and strengthen the capacity for an early response in underserved settings.
Accessed on 03/07/2025.
more
DIAGNOSIS, MANAGEMENT OF UNCOMPLICATED AND SEVERE MALARIA
Where malaria transmission is seasonal, notably in Africa’s Sahel region, children of all ages most at risk of severe malaria are protected throu
...
gh SMC. This intervention consists of full antimalarial treatment courses of sulfadoxine-pyrimethamine and amodiaquine (SPAQ), administered monthly (28 days) during the high-transmission period (typically the rainy season), generally for up to five months per year. SMC can be deployed relatively easily across a large population and is highly cost-effective at only USD $0.30-0.40/dose,3 making it an important tool for malaria control
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The faltering of progress towards malaria elimination follows a plateauing in international financing since 2010. Despite calls for increased international financing, this will be hard to achieve. Both developed country donors and developing countri
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es with malaria face severe fiscal constraints in expanding malaria funding in the next few years. Simply exhorting countries to spend more is unlikely to be successful, just as the Abuja declaration was not, and the developing countries with most malaria burden suffer from weaker economic growth and less capacity to increase domestic financing.
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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
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severe cases, recommend rapid tests and artemisinin-based therapies, and include special guidance for vulnerable groups like children and pregnant women.
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In the context of the Support to National Malaria Control Programme (SuNMaP), demand creation is the strategic combination of advocacy, communication and mobilisation approaches that seek to achieve increased community awareness of, and demand for,
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effective malaria prevention and treatment services. For malaria treatment, demand creation focuses on promoting improved testing, prompt and proper use of artemisinin combination therapy (ACT) treatment for individual cases of malaria, and effective home management of fever, together with referrals of severe cases to a higher-level health facility.
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Malaria in children presents significant clinical challenges, with variations in presentation based on the malaria parasite involved and the child's underlying health conditions. The World Health Or
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ganization reports high incidence rates, particularly in sub-Saharan Africa, and emphasizes the importance of effective treatment strategies. First-line treatment often involves Artemether-Lumefantrine (ALu), while severe malaria requires careful management and the use of intravenous Quinine. Management protocols emphasize early diagnosis and the monitoring of severe complications to reduce mortality.
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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 i
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n the region. In this paper, pertinent publications on the prevalence, impact, and treatment strategies 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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