From the Research
For infants 0-1 year old with malaria, the recommended treatment is Artemisinin-based Combination Therapy (ACT) with dosing based on the child's weight, as it is the most effective and safe option available, according to the most recent and highest quality study 1. The preferred ACT options include artemether-lumefantrine, artesunate-amodiaquine, dihydroartemisinin-piperaquine, or artesunate-mefloquine.
- For artemether-lumefantrine, infants weighing 5-14 kg typically receive 1 tablet (20 mg artemether/120 mg lumefantrine) twice daily for 3 days.
- For very small infants under 5 kg, dosing should be adjusted proportionally by a healthcare provider. Treatment should be administered for the full course (usually 3 days) even if symptoms improve quickly.
- The medication should be given with fatty foods when possible to improve absorption.
- Parents should be advised to return immediately if the infant vomits within 30 minutes of administration, develops worsening symptoms, or shows signs of severe malaria such as inability to feed, extreme lethargy, or convulsions. ACTs are effective because they combine fast-acting artemisinin derivatives that rapidly reduce parasite load with longer-acting partner drugs that eliminate remaining parasites and prevent recrudescence, as supported by studies 2, 3, 4. Weight-based dosing is critical in infants to ensure adequate drug levels while avoiding toxicity, and the emergence of artemisinin resistant parasites in SE Asia means that there is a need to optimise drug dosing and investigate novel therapies to maintain the impressive reduction in malaria mortality which has been seen in the past decade 1.