Monitoring of Malaria Therapy

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·         It is important to monitor Malaria therapy in order to evaluate if it is effective
·         Patients can be monitored clinically and/or by using laboratory test to confirm for absence/presence of malaria parasite in their blood

·         A follow-up period after the completion of the Malaria therapy varies according to the drugs used.

·         Follow-up periods longer than 14 days are appropriate for amodiaquine, chloroquine and SP which is 28 days

·         For lumefantrine+artemether is 42 days,
·         For mefloquine is 63 days
·         This allows drug levels in the blood to fall below the minimum therapeutic threshold.
·         Any recrudescence of parasites before this threshold is reached would be due to drug resistance
·         Recrudescence after this threshold is reached is not necessarily related to resistance (even sensitive parasites could recrudesce if blood drug levels are subtherapeutic).

·         Shorter follow-up (i.e. <14 days) will underestimate overall treatment failure rates
·         It is also important for patient to report any adverse reaction of the drugs that may occurs during Malaria therapy.

Woman Holding Black Stethoscope

References
Wells BG, DiPiro J, Schwinghammer T (2013), Pharmacotherapy Handbook (6th Ed). New York, NY: McGraw-Hill.

DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML, (2008): Pharmacotherapy: A Pathophysiologic Approach (7th ed): New York, NY: McGraw-Hill.

Katz M D., Matthias KR., Chisholm-Burns M A., Pharmacotherapy(2011) Principles & Practice Study Guide: A Case-Based Care Plan Approach: New York, NY: McGraw-Hill.

Schwinghammer TL, Koehler JM (2009) Pharmacotherapy Casebook: A Patient-Focused Approach (7th ed): New York, NY: McGraw-Hill.

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