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MIND
LINES
AGAINST
GUIDELINES
IN
TREATMENT
OF
MALARIA
…

malaria.
Sulfadoxine/pyrimethamine
and
artemether/lumefentrine
are

recommended
as
first
line
drugs
for
treatment
of
confirmed
cases
of

Plasmodium.falciparum.
Chloroquine
along
with
premaquine
combination
is
used

as
anti
relapse
therapeutic
agents
in
case
of
Plasmodium.vivax
(4)
(Table
1).

Table
1.-­-
Standard
treatment
guidelines
for
malaria
in
Pakistan.

Anti-malarial drugs Dosage Comments
form

Chloroquine is first choice of drug in all cases of malaria when type not confirmed
through laboratory test for empiriacl therapy

Standard treatment regimen for P.vivax

Chloroquine + Tablets Chloroquine 25mg/kg for 3days + primaquine
primaquine 0.25mg/kg O.D for 14 days.

Primaquine Tablets 0.75mg/kg body weight once a week for 8weeks.

Standard treatment regimen for confirmed cases of P.falciparum

Artemether Tablets Artemether 20mg +lumefantrine 120mg two
+lumefantrine doses per day for 3 days.

Artesunate Tablets Artesunate 20mg /kg O.D +tetracycline 4mg/kg
+tetracycline Q.I.D for 7days.

Dihydroartemisinin+ Tablets Dihydroartemisinin 4mg/kg/day +piperaquine
piperaquine 18mg/kg/day for 3days.

Single dose Tablets (0.75 mg/kg) to ACT treatment
piperaquine

*Directorate
of
Malaria
Control
and
WHO,
National
treatment
guidelines
for
malaria.
2005

Although,
standard
treatment
guidelines
are
available
in
the
country,
still

prescribing
and
dispensing
practices
are
not
up
to
the
desired
standards
in
public

and
private
healthcare
facilities
in
Pakistan
(5).

There
is
lack
of
research
on
evaluating
the
adherence
of
prescribing

practices
with
these
standard
treatment
guidelines,
which
in
turn
has
strong

influence
on
malaria
treatment
practices
(6).
Therefore,
the
main
objective
of
the

present
study
was
to
assess
the
adherence
of
prescribers
with
national
standard

treatment
guidelines
for
malaria
in
the
two
cities
of
Pakistan;
Islamabad
(national

capital)
and
in
its
twin
city
Rawalpindi.

The
study
will
provide
baseline
data
regarding
adherence
of
prescribers

with
standard
treatment
guidelines,
which
can
serve
as
a
basis
for
potential
areas

for
intervention
to
implement
the
standard
treatment
guidelines
effectively
to

improve
rational
drug
use
in
the
healthcare
system.

501