Table 1.

National treatment guidelines for malaria in Thailand

P. falciparum

First-line: DHA–PIP for 3 days + PQ single dose (30 mg or 0.5 mg base/kg, started on day 1 pending patient’s condition) (except for Sisaket and Ubon Ratchathani, where PY–AS for 3 days + PQ single dose was adopted in FY2019) Second-line (ACT): 1. PY–AS 3 days + PQ single dose; 2. AL for 3 days + PQ single dose; 3. AS–MQ for 3 days + PQ single dose Second-line (non-ACT): 1. Quinine + clindamycin–doxycycline–tetracycline for 7 days + PQ single dose; 2. Atovaquone–proguanil for 3 days + PQ single dose

P. vivax or P. ovale

First-line: CQ for 3 days + PQ (0.25 mg base/kg per day, started on day 3) for 14 days Second-line: DHA–PIP for 3 days + PQ for 14 days

P. malariae or P. knowlesi

First-line: CQ for 3 days Second-line: DHA–PIP for 3 days

P. falciparum plus P. vivax or P. ovale

DHA–PIP for 3 days + PQ for 14 days

P. falciparum plus P. malariae or P. knowlesi

DHA–PIP for 3 days + PQ single dose

Severe malaria

First-line: Artesunate injection within 24 h, followed by first-line/second-line regimen when tolerated + supportive care Second-line: Quinine injection within first 24 h followed by first-line/second-line regimen when tolerated + supportive care

Uncomplicated malaria in pregnancy 1st trimestera

Quinine + clindamycin for 7 days (P. falciparum or P. knowlesi) CQ for 3 days (P. vivax, P. ovale, or P. malariae)

Uncomplicated malaria in pregnancy 2nd or 3rd trimestera

DHA–PIP for 3 days (P. falciparum or P. knowlesi) CQ for 3 days (P. vivax, P. ovale, or P. malariae)

^aPrimaquine and doxycycline–tetracycline are contraindicated during pregnancy

ACT artemisinin-based combination therapy, DHA–PIP dihydroartemisinin–piperaquine, PQ primaquine, PY–AS pyronaridine–artesunate, AS–MQ artesunate–mefloquine, AL Artemether–lumefantrine, CQ chloroquine