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[Treatment of malaria in children: 1. Uncomplicated malaria]

P Imbert1, C Laurent

  • 1Service des Maladies infectieuses et Tropicales, Hôpital d'Instruction des Armées Bégin, 69, avenue de Paris, 94163 Saint-Mandé, France. hiabegin.mit@worldonline.fr

Medecine Tropicale : Revue Du Corps De Sante Colonial
|March 6, 2003
PubMed

Insights

Pediatric malaria is rising in France, primarily from Plasmodium falciparum. Current treatments like halofantrine and mefloquine have drawbacks, prompting research into effective malaria therapies for children.

Area of Science:

  • Tropical Medicine
  • Infectious Diseases
  • Pharmacology

Context:

  • Malaria poses a significant global health threat, particularly to young children, with increasing incidence in France.
  • Plasmodium falciparum accounts for over 80% of pediatric malaria cases in France, necessitating effective treatment strategies.
  • Current treatment guidelines recommend hospitalization for all malaria cases, impacting pediatric care.

Purpose:

  • To review current antimalarial drug therapies for pediatric malaria, focusing on Plasmodium falciparum.
  • To evaluate the efficacy and safety profiles of commonly used antimalarials, including halofantrine and mefloquine.
  • To discuss alternative and emerging treatments for malaria in children, considering drug resistance patterns.

Summary:

  • Halofantrine is widely used for uncomplicated Plasmodium falciparum malaria in children, but cardiotoxicity is a concern.
  • Mefloquine is an alternative, though its formulation and gastrointestinal side effects present challenges in pediatric use.
  • Chloroquine remains a standard for other Plasmodium species and in areas of moderate resistance; amodiaquine, sulfadoxine-pyrimethamine, and quinine are options for resistance or treatment failure.
  • Artemisinin derivative combinations show high efficacy, with ongoing evaluation for widespread use to combat resistance.

Impact:

  • Highlights the challenges in pediatric malaria treatment due to drug toxicity and formulation issues.
  • Underscores the need for safer and more effective antimalarial drugs for children globally.
  • Informs clinical practice and future research directions for managing pediatric malaria, especially in the context of evolving drug resistance.

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