From the Research
For uncomplicated malaria in infants 0-1 year old, the recommended treatment is a combination of Artesunate (ART) plus Sulfadoxine-Pyrimethamine (SP).
Key Considerations
- Artesunate should be administered at 4 mg/kg body weight once daily for 3 days
- Sulfadoxine-Pyrimethamine is given as a single dose on the first day of treatment (25 mg/kg of sulfadoxine and 1.25 mg/kg of pyrimethamine) 1
Administration and Monitoring
- The medication should be crushed and mixed with a small amount of water or breast milk to ensure complete administration
- Parents should be instructed to complete the full course even if symptoms improve quickly
- It's essential to monitor the infant for side effects such as vomiting, which may require dose repetition if it occurs within 30 minutes of administration
- Adequate hydration should be maintained throughout treatment, and the infant should be brought back for follow-up within 2-3 days to assess response to treatment
Rationale
This combination therapy is effective because artesunate rapidly reduces parasite load while SP provides a longer-acting component to clear remaining parasites 2.
Special Considerations
For very young infants under 5 kg, dosing should be carefully calculated based on exact weight, and close monitoring is particularly important.
Evidence Base
The efficacy and safety of artesunate plus SP in the treatment of uncomplicated P. falciparum malaria was evaluated in several studies, including a randomized trial of 600 children 3, and other studies that demonstrated the combination's effectiveness and safety 4, 1, 5, 2.