Paper II — 2024 December (Supplementary) (2019 Scheme) — Q7
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Paper II
2024 December (Supplementary) (2019 Scheme) · 100 marks · 180 min
Question
How will you treat a case of malaria. What is the treatment given for relapse. Mention the drugs which can
be given to prevent malaria while visiting an endemic area. (2+2+2)
Q76 marksShort Essays
Answer
Treatment of malaria
P. vivax: Chloroquine (blood schizonticide, for the acute attack) plus Primaquine (tissue schizonticide, for radical cure of hepatic hypnozoites).
P. falciparum (uncomplicated): full oral course of an Artemisinin-based Combination Therapy (ACT), e.g. Artemether + Lumefantrine, given chloroquine resistance.
Severe/complicated malaria: IV Artesunate (current first-line), or IV Quinine as an alternative.
Treatment for relapse
Relapse (specific to P. vivax/P. ovale) results from reactivation of dormant hepatic hypnozoites not cleared by the initial blood schizonticide alone. Treated with Primaquine, a tissue schizonticide specifically active against hypnozoites, given for 14 days for radical cure — screening for G6PD deficiency is required first, given primaquine’s hemolysis risk in deficient patients.
Drugs for chemoprophylaxis in endemic areas
Chloroquine, Doxycycline, or Mefloquine, started before travel and continued for a defined period after leaving the endemic area, chosen based on local resistance patterns and patient-specific contraindications.
