The use of rectal artesunate as a pre-referral treatment for severe Plasmodium falciparum malaria, 2023 update


Book Description

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 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. The outcomes of the review, including results of additional analyses undertaken by the WHO appointed experts, form the basis of this updated information note on the use of RAS as a pre-referral treatment for severe Plasmodium falciparum malaria.




Guidelines for the Treatment of Malaria. Third Edition


Book Description

Malaria remains an important cause of illness and death in children and adults in countries in which it is endemic. Malaria control requires an integrated approach including prevention (primarily vector control) and prompt treatment with effective antimalarial agents. Malaria case management consisting of prompt diagnosis and effective treatment remains a vital component of malaria control and elimination strategies. Since the publication of the first edition of the Guidelines for the treatment of malaria in 2006 and the second edition in 2010 all countries in which P. falciparum malaria is endemic have progressively updated their treatment policy from use of ineffective monotherapy to the currently recommended artemisinin-based combination therapies (ACT). This has contributed substantially to current reductions in global morbidity and mortality from malaria. Unfortunately resistance to artemisinins has arisen recently in P. falciparum in South-East Asia which threatens these gains. This third edition of the WHO Guidelines for the treatment of malaria contains updated recommendations based on a firmer evidence base for most antimalarial drugs and in addition include recommendation on the use of drugs to prevent malaria in groups at high risk. The Guidelines provide a framework for designing specific detailed national treatment protocols taking into account local patterns of resistance to antimalarial drugs and health service capacity. It provides recommendations on treatment of uncomplicated and severe malaria in all age groups all endemic areas in special populations and several complex situations. In addition on the use of antimalarial drugs as preventive therapy in healthy people living in malaria-endemic areas who are high risk in order to reduce morbidity and mortality from malaria. The Guidelines are designed primarily for policy-makers in ministries of health who formulate country-specific treatment guidelines. Other groups that may find them useful include health professionals and public health and policy specialists that are partners in health or malaria control and the pharmaceutical industry. The treatment recommendations in the main document are brief; for those who wish to study the evidence base in more detail a series of annexes is provided with references to the appropriate sections of the main document.




Technical consultation to review the effectiveness of rectal artesunate used as pre-referral treatment of severe malaria in children


Book Description

This document is the report of a WHO technical consultation of independent experts convened in October 2022. The aim of the consultation was to conduct a formal evidence review of several studies evaluating the effectiveness of rectal artesunate (RAS) as a pre-referral treatment for severe malaria. In addition to the study published under the Community Access to Rectal Artesunate for Malaria Project, the review included other studies from early-use countries deploying RAS at the programmatic level. The main objective of the technical consultation was to support the development of guidance for the safe and effective implementation of this intervention based on the evidence from areas where RAS has already been implemented.




Saving Lives, Buying Time


Book Description

For more than 50 years, low-cost antimalarial drugs silently saved millions of lives and cured billions of debilitating infections. Today, however, these drugs no longer work against the deadliest form of malaria that exists throughout the world. Malaria deaths in sub-Saharan Africaâ€"currently just over one million per yearâ€"are rising because of increased resistance to the old, inexpensive drugs. Although effective new drugs called "artemisinins" are available, they are unaffordable for the majority of the affected population, even at a cost of one dollar per course. Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance examines the history of malaria treatments, provides an overview of the current drug crisis, and offers recommendations on maximizing access to and effectiveness of antimalarial drugs. The book finds that most people in endemic countries will not have access to currently effective combination treatments, which should include an artemisinin, without financing from the global community. Without funding for effective treatment, malaria mortality could double over the next 10 to 20 years and transmission will intensify.




Guidelines for the Treatment of Malaria


Book Description

"The purpose of this document is to provide comprehensible, global, evidence-based guidelines to help formulate policies and protocols for the treatment of malaria. Information is presented on the treatment of uncomplicated malaria, including disease in special groups (young children, pregnant women, people who are HIV positive, travellers from non-malaria endemic regions) and in complex emergency situations and severe malaria."--Publisher's description.




Management of Severe Malaria


Book Description

Malaria continues to be a major health problem in many parts of the world, with over 2,400 million people in 100 countries at risk of infection. This handbook is an updated edition of 'Management of severe and complicated malaria', providing practical guidance on the diagnosis and management of severe falciparum malaria, a form of the disease that can have life-threatening complications if treatment is delayed.




Disease Control Priorities, Third Edition (Volume 6)


Book Description

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.




The use of rectal artesunate as a pre-referral treatment for severe P. falciparum malaria


Book Description

The WHO Malaria Policy Advisory Group (MPAG) recently reviewed the evidence from a large-scale study in 3 African countries deploying rectal artesunate under real-life conditions. This information note shares the findings of the study and possible implications for the use of RAS as pre-referral treatment for severe malaria, and makes concrete recommendations for countries to consider. The WHO Global Malaria Programme, in consultation with other relevant departments, will conduct a formal evidence review and develop detailed guidance on the conditions under which the use of this tool can be implemented safely and effectively. Such guidance will be shared with countries as soon as it becomes available.




Medical Parasitology


Book Description

This textbook will provide a systematic comprehension of the various medically important human parasites; their distribution, habitat, morphology and life cycle, pathogenesis and clinical features, laboratory diagnosis, treatment, prevention and control. The main emphasis is on the protozoan and helminthic diseases, also medical entomology covering vectors relevant to these diseases. The book aims to promote an easy yet comprehensive way of learning parasitology. It attempts to break down the complexity of medical parasitology into parts that are easy to understand yet integrating the essential information of parasitic infections. The integration of knowledge of parasites will be achieved through student friendly illustrations, inclusion of a collection of recent case reports, examples of test questions and scenarios, and the images of human parasites. Essentially, it provides a “one-stop learning package” for medical parasitology.




Malaria Control and Elimination in China


Book Description

This volume provides cutting-edge research from malaria parasitology and records the success story of disease control in China. The country, which was certified malaria-free by the World Health Organization in 2021, looks back on 70 years of effort and fruitful combat history. Expert authors supply insights from Plasmodium morphology to the clinical picture of malaria, molecular and immunodiagnosis, as well as current treatment and resistance issues, making this book a valuable blueprint for further success stories. The present work makes a significant contribution to the Sustainable Development Goal (SDG) 3, Good Health and Well-Being, with the aim to end malaria epidemics by 2030. Practical details of malaria elimination tools and strategies are completed by chapters on artificial intelligence in diagnosis and also traditional Chinese medicines for therapy. All researchers involved in malaria control and elimination around the globe will benefit from the knowledge presented, including students, scientists, policy makers at various levels, and professionals in healthcare and antiparasitic drug discovery.