From the Research
The treatment of malaria in Papua New Guinea (PNG) should follow a comprehensive regime based on the national treatment guidelines, with artemether-lumefantrine (AL) as the first-line treatment for uncomplicated Plasmodium falciparum malaria, as evidenced by the most recent study in 2018 1.
Treatment Regime
For uncomplicated Plasmodium falciparum malaria, the first-line treatment is artemether-lumefantrine (AL), administered as a 3-day course with doses based on body weight. Adults typically receive 4 tablets twice daily for 3 days, while children receive weight-appropriate dosing.
- The day-42 PCR-corrected ACPR for P. falciparum was 98.1% for AL, as reported in the 2018 study 1.
- For severe malaria, intravenous artesunate is recommended at 2.4 mg/kg given at 0,12, and 24 hours, then daily until oral therapy can be tolerated, followed by a complete course of AL.
Plasmodium Vivax Infections
For Plasmodium vivax infections, chloroquine (25 mg/kg divided over 3 days) plus primaquine (0.25 mg/kg daily for 14 days) is used, with G6PD testing recommended before primaquine administration to prevent hemolysis in deficient patients.
- The day-42 PCR-corrected ACPR for P. vivax was 79.0% for AL and 92.3% for dihydroartemisinin-piperaquine (DHA-PPQ), as reported in the 2018 study 1.
Pregnant Women
Pregnant women in their first trimester with uncomplicated malaria receive oral quinine plus clindamycin, while those in second and third trimesters can receive AL.
- The treatment of uncomplicated malaria during pregnancy consists of an artemisinin-based combination therapy (ACT), such as artemether-lumefantrine, as reported in the 2019 study 2.
National Treatment Guidelines
The PNG guidelines emphasize parasitological confirmation before treatment, patient monitoring for treatment response, and follow-up to ensure complete parasite clearance.
- The guidelines reflect the country's adaptation to local resistance patterns, particularly the widespread chloroquine resistance in P. falciparum, and aim to reduce transmission while preventing progression to severe disease, as reported in the 2018 study 1.