Editing Malaria (section)

===Uncomplicated malaria===
Simple or uncomplicated malaria may be treated with oral medications. Artemisinin drugs are effective and safe in treating uncomplicated malaria.<ref>{{cite journal | vauthors = McIntosh HM, Olliaro P | title = Artemisinin derivatives for treating uncomplicated malaria | journal = The Cochrane Database of Systematic Reviews | volume = 1999 | issue = 2 | pages = CD000256 | date = 1999-04-26 | pmid = 10796519 | pmc = 6532741 | doi = 10.1002/14651858.CD000256 | collaboration = Cochrane Infectious Diseases Group }}</ref> Artemisinin in combination with other antimalarials (known as [[artemisinin-combination therapy]], or ACT) is about 90% effective when used to treat uncomplicated malaria.<ref name="Howitt-2012" /> The most effective treatment for ''P.&nbsp;falciparum'' infection is the use of ACT, which decreases resistance to any single drug component.<ref>{{cite journal | vauthors = Pousibet-Puerto J, Salas-Coronas J, Sánchez-Crespo A, Molina-Arrebola MA, Soriano-Pérez MJ, Giménez-López MJ, Vázquez-Villegas J, Cabezas-Fernández MT | title = Impact of using artemisinin-based combination therapy (ACT) in the treatment of uncomplicated malaria from Plasmodium falciparum in a non-endemic zone | journal = Malaria Journal | volume = 15 | issue = 1 | pages = 339 | date = July 2016 | pmid = 27368160 | pmc = 4930579 | doi = 10.1186/s12936-016-1408-1 | s2cid = 18043747 | doi-access = free }}</ref><ref name="Kokwaro-2009" /> Artemether-lumefantrine (six-dose regimen) is more effective than the artemether-lumefantrine (four-dose regimen) or other regimens not containing artemisinin derivatives in treating falciparum malaria.<ref>{{cite journal | vauthors = Omari AA, Gamble C, Garner P | title = Artemether-lumefantrine (four-dose regimen) for treating uncomplicated falciparum malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2006 | issue = 2 | pages = CD005965 | date = April 2006 | pmid = 16625646 | pmc = 6532603 | doi = 10.1002/14651858.CD005965 | collaboration = Cochrane Infectious Diseases Group }}</ref><ref>{{cite journal | vauthors = Omari AA, Gamble C, Garner P | title = Artemether-lumefantrine (six-dose regimen) for treating uncomplicated falciparum malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2005 | issue = 4 | pages = CD005564 | date = October 2005 | pmid = 16235412 | pmc = 6532733 | doi = 10.1002/14651858.CD005564 | collaboration = Cochrane Infectious Diseases Group }}</ref> Another recommended combination is [[dihydroartemisinin]] and [[piperaquine]].{{sfn|WHO|2015|p=9}}<ref name="Keating-2012" /><ref>{{cite journal | vauthors = Sinclair D, Zani B, Donegan S, Olliaro P, Garner P | title = Artemisinin-based combination therapy for treating uncomplicated malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2009 | issue = 3 | pages = CD007483 | date = July 2009 | pmid = 19588433 | pmc = 6532584 | doi = 10.1002/14651858.CD007483.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> Artemisinin-naphthoquine combination therapy showed promising results in treating falciparum malaria but more research is needed to establish its efficacy as a reliable treatment.<ref>{{cite journal | vauthors = Isba R, Zani B, Gathu M, Sinclair D | title = Artemisinin-naphthoquine for treating uncomplicated Plasmodium falciparum malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 2 | pages = CD011547 | date = February 2015 | pmid = 25702785 | pmc = 4453860 | doi = 10.1002/14651858.CD011547 | collaboration = Cochrane Infectious Diseases Group }}</ref> Artesunate plus mefloquine performs better than mefloquine alone in treating uncomplicated falciparum malaria in low transmission settings.<ref>{{cite journal | vauthors = Bukirwa H, Orton L | title = Artesunate plus mefloquine versus mefloquine for treating uncomplicated malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2005 | issue = 4 | pages = CD004531 | date = October 2005 | pmid = 16235367 | pmc = 6532646 | doi = 10.1002/14651858.CD004531.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> Atovaquone-proguanil is effective against uncomplicated falciparum with a possible failure rate of 5% to 10%; the addition of artesunate may reduce failure rate.<ref>{{cite journal | vauthors = Blanshard A, Hine P | title = Atovaquone-proguanil for treating uncomplicated Plasmodium falciparum malaria | journal = The Cochrane Database of Systematic Reviews | volume = 1 | issue = 1 | pages = CD004529 | date = January 2021 | pmid = 33459345 | pmc = 8094970 | doi = 10.1002/14651858.CD004529.pub3 }}</ref> Azithromycin monotherapy or combination therapy has not shown effectiveness in treating ''Plasmodium falciparum'' or ''Plasmodium vivax'' malaria.<ref>{{cite journal | vauthors = van Eijk AM, Terlouw DJ | title = Azithromycin for treating uncomplicated malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2011 | issue = 2 | pages = CD006688 | date = February 2011 | pmid = 21328286 | pmc = 6532599 | doi = 10.1002/14651858.CD006688.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> Amodiaquine plus sulfadoxine-pyrimethamine may achieve less treatment failures when compared to sulfadoxine-pyrimethamine alone in uncomplicated falciparum malaria.<ref>{{cite journal | vauthors = McIntosh HM, Jones KL | title = Chloroquine or amodiaquine combined with sulfadoxine-pyrimethamine for treating uncomplicated malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2005 | issue = 4 | pages = CD000386 | date = October 2005 | pmid = 16235276 | pmc = 6532604 | doi = 10.1002/14651858.CD000386.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> There is insufficient data on chlorproguanil-dapsone in treating uncomplicated falciparum malaria.<ref>{{cite journal | vauthors = Amukoye E, Winstanley PA, Watkins WM, Snow RW, Hatcher J, Mosobo M, Ngumbao E, Lowe B, Ton M, Minyiri G, Marsh K | title = Chlorproguanil-dapsone: effective treatment for uncomplicated falciparum malaria | journal = Antimicrobial Agents and Chemotherapy | volume = 41 | issue = 10 | pages = 2261–2264 | date = October 1997 | pmid = 9333058 | pmc = 164103 | doi = 10.1128/AAC.41.10.2261 }}</ref><ref>{{cite journal | vauthors = Bukirwa H, Garner P, Critchley J | title = Chlorproguanil-dapsone for treating uncomplicated malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2004 | issue = 4 | pages = CD004387 | date = October 2004 | pmid = 15495106 | pmc = 6532720 | doi = 10.1002/14651858.CD004387.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> The addition of primaquine with artemisinin-based combination therapy for falciparum malaria reduces its transmission at day 3–4 and day 8 of infection.<ref>{{cite journal | vauthors = Graves PM, Choi L, Gelband H, Garner P | title = Primaquine or other 8-aminoquinolines for reducing Plasmodium falciparum transmission | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | issue = 2 | pages = CD008152 | date = February 2018 | pmid = 29393511 | pmc = 5815493 | doi = 10.1002/14651858.CD008152.pub5 | collaboration = Cochrane Infectious Diseases Group }}</ref> Sulfadoxine-pyrimethamine plus artesunate is better than sulfadoxine-pyrimethamine plus amodiaquine in controlling treatment failure at day 28. However, the latter is better than the former in reducing gametocytes in blood at day 7.<ref>{{cite journal | vauthors = Bukirwa H, Critchley J | title = Sulfadoxine-pyrimethamine plus artesunate versus sulfadoxine-pyrimethamine plus amodiaquine for treating uncomplicated malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2006 | issue = 1 | pages = CD004966 | date = January 2006 | pmid = 16437507 | pmc = 6532706 | doi = 10.1002/14651858.CD004966.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref>

Infection with ''P.&nbsp;vivax'', ''P.&nbsp;ovale'' or ''P.&nbsp;malariae'' usually does not require hospitalisation. Treatment of ''P.&nbsp;vivax'' malaria requires both elimination of the parasite in the blood with chloroquine or with artemisinin-based combination therapy and clearance of parasites from the liver with an [[8-aminoquinoline]] agent such as [[primaquine]] or [[tafenoquine]].<ref name="Waters-2011" /><ref>{{cite journal | vauthors = Rodrigo C, Rajapakse S, Fernando D | title = Tafenoquine for preventing relapse in people with Plasmodium vivax malaria | journal = The Cochrane Database of Systematic Reviews | volume = 9 | issue = 9 | pages = CD010458 | date = September 2020 | pmid = 32892362 | pmc = 8094590 | doi = 10.1002/14651858.CD010458.pub3 }}</ref> These two drugs act against blood stages as well, the extent to which they do so still being under investigation.<ref>{{cite journal | vauthors = Markus MB | title = Putative Contribution of 8-Aminoquinolines to Preventing Recrudescence of Malaria | journal = Tropical Medicine and Infectious Disease | volume = 8 | issue = 5 | page = 278 | date = May 2023 | pmid = 37235326 | pmc = 10223033 | doi = 10.3390/tropicalmed8050278 | doi-access = free }}</ref>

To treat malaria during pregnancy, the [[World Health Organization|WHO]] recommends the use of quinine plus [[clindamycin]] early in the pregnancy (1st trimester), and ACT in later stages (2nd and 3rd trimesters).<ref>{{cite journal | vauthors = Tarning J | title = Treatment of Malaria in Pregnancy | journal = The New England Journal of Medicine | volume = 374 | issue = 10 | pages = 981–982 | date = March 2016 | pmid = 26962733 | doi = 10.1056/NEJMe1601193 | url = https://ora.ox.ac.uk/objects/uuid:e67b1397-c8ed-493f-a61e-f265d8a41c11 | access-date = 2023-01-15 | url-status = live | doi-access = free | archive-url = https://web.archive.org/web/20230426202218/https://ora.ox.ac.uk/objects/uuid:e67b1397-c8ed-493f-a61e-f265d8a41c11 | archive-date = 2023-04-26 }}</ref><ref name="Manyando-2012" /> There is limited safety data on the antimalarial drugs in pregnancy.<ref>{{cite journal | vauthors = Orton LC, Omari AA | title = Drugs for treating uncomplicated malaria in pregnant women | journal = The Cochrane Database of Systematic Reviews | volume = 2008 | issue = 4 | pages = CD004912 | date = October 2008 | pmid = 18843672 | pmc = 6532683 | doi = 10.1002/14651858.CD004912.pub3 | collaboration = Cochrane Infectious Diseases Group }}</ref>