training module for medical officers primary health centre - NVBDCP

within 72 hours of treatment. Such individual patients should be given alternative drug i.e. ACTcombination and report to concerned District Malaria / State Malaria Officer/ROHFW Pf monitoringteams for monitoring of drug sensitivity status.ACT should be given only to confirmed P. falciparum cases found positive by microscopy or RapidDiagnostic kits. The dose is 4mg/kg body weight of Artesunate (AS) daily for 3 days, combined with25mg/ kg body weight of sulphadoxine/sulphalene + 1.25 mg per kg body weight of pyrimethamine(SP) on the first day. Artesunate tablets should not be administered as mono therapy. It shouldinvariably be combined with sulpha pyrimethamine tablets in prescribed dosages. Strength of eachArtesunate tablet: is 50 mg and each Sulpha Pyrimethamine (SP) tablet contain 500mgsulphadoxine/sulphalene and 25mg pyrimethamineACT Dosage Schedule for Plasmodium falciparum cases * - 3 DaysAge1 st Day(Number of tabs)*2 nd Day(Number of tabs)3 rd Day(Numbers of tabs)< 1 year ASSP1 - 4 years ASSP5 - 8 years ASSP9 - 14 years ASSP15 years and ASabove SP½¼1121 ½3243½Nil1Nil2Nil3Nil4Nil½Nil1Nil2Nil3Nil4NilAS- ArtesunateSP- Sulpha-PyrimethamineA single dose of Primaquine i.e. 0.75 mg/kg body weight, is recommended to be given with ACTcombination as it will enhance gametocyte clearance and facilitate interruption of transmission.Primaquine should also be not used in pregnant women and infants. As per current National PolicyArtemisinin derivatives are not to be used in pregnant women.As per the current National policy, in all states not mentioned above and in areas not known to havechloroquine resistance, microscopically positive Pf cases should be treated with chloroquine intherapeutic dose of 25 mg/kg body weight divided over three days (similar to P. vivax cases) and asingle dose of Primaquine 0.75 mg/kg body weight on the first day.34