In Practice

Maintaining focus on administering effective malaria treatment during the COVID-19 pandemic

J Raman, K I Barnes, L Baker, M Blaylock, L Blumberg, J Frean, E Misiani, I S Ukpe

Abstract


As September marks the start of the malaria season in South Africa (SA), it is essential that healthcare professionals consider both COVID- 19 and malaria when a patient who lives in or has recently travelled to a malaria area presents with acute febrile illness. Early diagnosis of malaria by either a rapid diagnostic test or microscopy enables prompt treatment with the effective antimalarial, artemether-lumefantrine, preventing progression to severe disease and death. Intravenous artesunate is the preferred treatment for severe malaria in both children and adults. Adding single low-dose primaquine to standard treatment is recommended in endemic areas to block onward transmission. Use of the highly effective artemisinin-based therapies should be limited to the treatment of confirmed malaria infections, as there is no clinical evidence that these antimalarials can prevent or treat COVID-19. Routine malaria case management services must be sustained, in spite of COVID-19, to treat malaria effectively and support SA’s malaria elimination efforts.


Authors' affiliations

J Raman, Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, University of Pretoria, South Africa

K I Barnes, Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; WorldWide Antimalarial Resistance Network (WWARN), Division of Pharmacology, Faculty of Health Sciences, University of Cape Town, South Africa

L Baker, Amayeza Info Services, Johannesburg, South Africa

M Blaylock, KwaZulu-Natal Provincial Department of Health, Manguzi, South Africa

L Blumberg, Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Faculty of Veterinary Medicine, University of Pretoria, South Africa

J Frean, Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

E Misiani, Malaria and Other Vector-Borne and Zoonotic Diseases Directorate, National Department of Health, Pretoria, South Africa

I S Ukpe, Mpumalanga Provincial Department of Health, Mbombela, South Africa; Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

Full Text

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Keywords

Malaria; Treatment; Diagnosis; IV artesunate; Severe malaria; Rapid diagnostic test; Artemether-lumefantrine; Primaquine; COVID-19

Cite this article

South African Medical Journal 2021;111(1):13-16. DOI:10.7196/SAMJ.2020.v111i11.15289

Article History

Date submitted: 2020-11-23
Date published: 2020-11-23

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