WHO Guidelines for malaria - 16 February 2021

Published by World Health Organization (WHO) on Feb 15, 2021

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Funding for the development and publication of the Guidelines was gratefully received from the Bill & Melinda Gates Foundation; the Spanish Agency for International Development Cooperation, Unitaid, and the United States Agency for International Development (USAID).

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Abstract

This document is a PDF generated from the WHO Guidelines for malaria hosted on the MAGICapp online platform: https://app.magicapp.org/#/guideline/4807. Each time the content of the platform is updated, a new PDF version of the Guidelines will be downloadable on the WHO Global Malaria Programme website to facilitate access where the internet is not available. Uswers should note the downloaded PDFs of the Guidelines may be outdated and not contain the latest recommendations. Please consult with the WHO Global Malaria Programme website for the most up-to-date version of the Guidelines (https://www.who.int/teams/global-malaria-programme).

WHO/UCN/GMP/2021.01

Language

en

PICOS

PICO 1.1

Population
Children with severe malaria (malaria-endemic areas)
Intervention
Artesunate
Comparator
Quinine
Outcomes

PICO 1.1

Population
Adults and children with uncomplicated falciparum malaria (malaria-endemic areas in Africa and Asia)
Intervention
Artesunate + pyronaridine once daily for 3 days
Comparator
Artemether + lumefantrine twice daily for 3 days
Outcomes

PICO 1.1

Population
People at risk of malaria
Intervention
Insecticide-treated nets or curtains
Comparator
No nets
Outcomes

PICO 1.1

Population
Malaria-endemic areas
Intervention
Three or more doses of sulfadoxine–pyrimethamine
Comparator
Two doses of sulfadoxine–pyrimethamine
Outcomes

PICO 1.2

Population
Malaria-endemic areas
Intervention
Three or more doses of sulfadoxine–pyrimethamine
Comparator
Two doses of sulfadoxine–pyrimethamine
Outcomes

PICO 1.2

Population
Adults with severe malaria (malaria-endemic areas)
Intervention
Artesunate
Comparator
Quinine
Outcomes

PICO 1.2

Population
People with uncomplicated falciparum malaria (malaria-endemic areas in Africa and Asia)
Intervention
Artesunate + pyronaridine once daily for 3 days
Comparator
Artesunate + mefloquine once daily for 3 days
Outcomes

PICO 1.2

Population
People at risk of malaria
Intervention
Insecticide-treated nets or curtains
Comparator
Untreated nets
Outcomes

PICO 1.3

Population
People at risk of malaria
Intervention
Pyrethroid-PBO nets
Comparator
LLIN
Outcomes

PICO 1.3

Population
People with uncomplicated falciparum malaria (high- and low-transmission settings for P. falciparum and P. vivax malaria)
Intervention
Pyronaridine alone or with an artemisinin derivative
Comparator
Another antimalarial drug
Outcomes

PICO 1.4

Population
Adults and children with uncomplicated P. falciparum malaria (malaria-endemic settings)
Intervention
Artemisinin + naphthoquine; 1-day course
Comparator
Artemether + lumefantrine twice daily for 3 days
Outcomes

PICO 1.4

Population
People at risk of malaria
Intervention
IRS
Comparator
no IRS
Outcomes

PICO 1.5

Population
Adults and children with uncomplicated P. falciparum malaria (malaria-endemic settings)
Intervention
Artemisinin + naphthoquine; 1-day course
Comparator
Dihydroartemisinin + piperaquine; 3-day course
Outcomes

PICO 1.5

Population
People at risk of malaria
Intervention
IRS
Comparator
ITNs
Outcomes

PICO 1.6

Population
People at risk of malaria
Intervention
IRS
Comparator
ITNs
Outcomes

PICO 1.7

Population
People at risk of malaria
Intervention
IRS + ITNs
Comparator
ITNs
Outcomes

PICO 1.8

Population
People at risk of malaria
Intervention
Larviciding
Comparator
no larviciding
Outcomes

PICO 1.9

Population
People at risk of malaria
Intervention
Larvivorous fish
Comparator
no larvivorous fish
Outcomes

PICO 1.10

Population
People at risk of malaria
Intervention
Topical repellent
Comparator
placebo or no topical repellent
Outcomes

PICO 1.11

Population
People at risk of malaria
Intervention
Insecticide-treated clothing
Comparator
placebo or untreated clothing
Outcomes

PICO 1.12

Population
People at risk of malaria
Intervention
Spatial/airborne repellents
Comparator
placebo or no malaria prevention intervention
Outcomes

PICO 1.13

Population
People at risk of malaria
Intervention
Space spraying
Comparator
no space spraying
Outcomes

PICO 1.14

Population
People at risk of malaria
Intervention
Space spraying
Comparator
no space spraying
Outcomes

PICO 2.1

Population
Patients with uncomplicated P. falciparum malaria (malaria-endemic settings in Africa)
Intervention
Dihydroartemisinin + piperaquine once daily for 3 days
Comparator
Artemether + lumefantrine twice daily for 3 days
Outcomes

PICO 2.1

Population
Adults with severe malaria (malaria-endemic countries)
Intervention
Intramuscular artemether
Comparator
Intravenous or intramuscular artesunate
Outcomes

PICO 2.2

Population
Patients with uncomplicated P. falciparum malaria (malaria-endemic settings in Africa)
Intervention
Dihydroartemisinin + piperaquine once daily for 3 days
Comparator
Artesunate + mefloquine once daily for 3 days
Outcomes

PICO 2.2

Population
Children with severe malaria (malaria-endemic countries)
Intervention
Intramuscular artemether
Comparator
Intravenous or intramuscular quinine
Outcomes

PICO 2.3

Population
Patients with uncomplicated P. falciparum malaria (malaria-endemic settings in Africa)
Intervention
Dihydroartemisinin + piperaquine
Comparator
Artemether + lumefantrine
Outcomes

PICO 2.3

Population
Adults with severe malaria (malaria-endemic countries)
Intervention
Intramuscular artemether
Comparator
Intravenous or intramuscular quinine
Outcomes

PICO 2.4

Population
Patients with uncomplicated P. falciparum malaria (malaria-endemic settings in Africa)
Intervention
Dihydroartemisinin + piperaquine
Comparator
Artesunate + mefloquine
Outcomes

PICO 3.1

Population
Adults and children with uncomplicated malaria (malaria-endemic settings)
Intervention
Artesunate 4 mg/kg bw once daily for 3 days plus sulfadoxine–pyrimethamine on day 1
Comparator
Artesunate 4 mg/kg bw once daily for 1 day plus sulfadoxine–pyrimethamine on day 1
Outcomes

PICO 3.1

Population
Children aged < 5 years (areas with seasonal transmission)
Intervention
Regular full treatment doses of antimalarial medicines (amodiaquine + sulfadoxine–pyrimethamine, artesunate + sulfadoxine–pyrimethamine or sulfadoxine–pyrimethamine alone) every 1–2 months during the malaria transmission season
Comparator
Placebo
Outcomes

PICO 3.1

Population
Children aged < 5 years with severe malaria (rural settings in Africa and Asia where parenteral treatment is not available)
Intervention
Rectal artesunate plus referral for definitive treatment
Comparator
Placebo plus referral for definitive treatment
Outcomes

PICO 3.2

Population
Children aged > 6 years and adults with severe malaria (rural settings where parenteral treatment is not available)
Intervention
Rectal artesunate plus referral for definitive treatment
Comparator
Placebo plus referral for definitive treatment
Outcomes

PICO 4.1

Population
Adults and children with uncomplicated P. vivax malaria (Malaria-endemic areas in which chloroquine is still effective for the first 28 days)
Intervention
Artemisinin-based combination therapy
Comparator
Chloroquine
Outcomes

PICO 4.2

Population
Adults and children with uncomplicated P. vivax malaria (Settings with high transmission of P. vivax (chloroquine resistance is also reported as high))
Intervention
Dihydroartemisinin + piperaquine
Comparator
Alternative ACTs
Outcomes

PICO 4.3

Population
People with P. vivax malaria
Intervention
Primaquine (0.25 mg/kg bw) for 14 days plus chloroquine (25 mg/kg bw for 3 days)
Comparator
Chloroquine alone (25 mg/kg bw for 3 days)
Outcomes

PICO 4.4

Population
People with P. vivax malaria
Intervention
Primaquine (0.25 mg/kg bw) for 14 days plus chloroquine (25 mg/kg bw for 3 days)
Comparator
Primaquine (0.25 mg/kg bw) for 7 days plus chloroquine alone (25 mg/kg bw for 3 days)
Outcomes

PICO 4.5

Population
Malaria-endemic areas
Intervention
Chloroquine prophylaxis
Comparator
Placebo
Outcomes

PICO 5.1

Population
People with symptomatic malaria in malaria-endemic areas
Intervention
Short-course primaquine plus malaria treatment including an artemisinin derivative
Comparator
Malaria treatment with an artemisinin derivative alone
Outcomes