Medical treatment of malaria

Eleven patients with 14 episodes of malaria have been admitted to Kaohsiung Medical College Hospital in the past 10 years and have been evaluated in this study. All of the patients were male and had traveling history to Africa or Southeast Asia. Eight of them were suffering from falciparum malaria and three vivax malaria. Initially they were treated with chloroquine (900 mg + 300 mg x 2 d) and primaquine (15 mg x 14 d). Quinine (650 mg q8h x 7-10 d) was used in one severe and another reinfected case of falciparum malaria. Cerebral malaria was noted in two falciparum cases with good response to treatment. One severe patient who also suffered from black water fever died of acute renal failure, even though quinine had been given immediately. It is concluded that chloroquine combined with primaquine is effective and safe in the treatment of vivax and falciparum malaria in Taiwan. Quinine should be given as soon as possible in a severe case of falciparum malaria. Supportive management and basic knowledge of epidemiology is also very important in the medical treatment of malaria.