Ans. is ‘a’ i.e., Infant parasite index is a poor index for assessment for transmission of malaria in the community
Correct Answer: Chloraquine + Primaquine
Description: Ans. is 'c' i.e., Chloroquine + Primaquine o Previously presumptive treatment to suspected cases of malaria was used (Chloroquine + Primaquine). o But policy has changed now. - Read below Guidelines for diagnosis and treatment of Malaria - 2010 (Added in 22/e of Park) o According to the revised drug policy, there is no scope of presumptive treatment in malaria control. The new drug policy gives emphasis on complete treatment in diagnosed cases of malaria rather than one single dose presumptive treatment to suspected cases of malaria (waiting for the diagnosis) to avoid chloroquine resistance in P. falciparum. o All fever cases should be investigated for malaria either by microscopy or by Rapid diagnostic Test (RDT) for both vivax & falciparum, i.e., combo RDT. o Fuher treatment is as follows : - 1)For plasmodium vivax : - 3 days chlorquine plus 14 days Primaquine. 2) For plasmodium falciparum : ? All cases should be given Aemisinin combination therapy (ACT) which includes Aesunate (for 3 days) along with sulfadoxin-pyrimethamine (on day 0) plus single dose primaquine. 3) Treatment of mixed infection : - Should be treated as falciparum malaria. 4) When microscopy results are not available within 24 hours or if RDT for only falciparum is used : - a)P. falciparum RDT positive --> Treat as falciparum malaria (as above). b)P. falciparum RDT negative --> Send blood slide to laboratory, and give chloroquine for 3 days, and await microscopy results : - i) +ve for vivax --> Primaquine for 14 days. ii) +ve for falciparum --> Treatment of falciparum malaria as above. 5)Treatment of severe malaria : - Severe manifestations (e.g., Unconsciousness, Convulsions, Coma, Metabolic acidosis etc) can develop in P. falciparum infection. Treatment is as follows : - i) Sta with parentral aimisinin derivative (aesunate, aemether, aeether) or quinine. ii)Once patient can take oral therapy : ? a) Patients receiving parentral quinine should be treated with oral quinine along with doxycyclin for 7 days. In pregnant women clindamycin is given instead of doxycyclin. b)Patients receiving aemisinin derivatives should get full course of oral ACT. Treatment of malaria in pregnancy has also been included in 22n4/e of Park Treatment in pregnancy i) Falciparum malaria : - ACT in 2nd & 3rd trimester; quinine in first trimester. ii) Vivax malaria : - chloroquine
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