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Malaria ACT Dosing

Weight-band ACT dosing aligned to Nigeria STG 2022, with pregnancy-trimester and G6PD-aware regimen selection.

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This tool picks the correct antimalarial regimen for a patient based on weight, pregnancy status and trimester, disease severity, and G6PD status — it isn't a single formula, it's a decision tree that lands on one of several Nigeria STG 2022 regimens. See How Calculator Tools Work for the shared layout.

Inputs

  • Weight (kg) — the tool is not validated below 5 kg and blocks a result entirely under that threshold, recommending paediatric specialist referral instead
  • Age (months)
  • Pregnancy status — not pregnant, or pregnant (with trimester 1/2/3 if pregnant)
  • Malaria type — uncomplicated or severe
  • G6PD status — unknown, normal, or deficient
  • First-line contraindicated — whether Artemether-Lumefantrine is unsuitable for this patient

How the regimen is chosen

  1. Severe malaria (any patient) → IV/IM Artesunate, 2.4 mg/kg, at 0, 12, 24, then 48 hours, continued daily until the patient can tolerate oral medication. This is flagged as a medical emergency requiring hospital admission regardless of any other input.
  2. Pregnant, first trimester, severe → IV Artesunate as above, with an explicit note that IV artesunate is used in T1 because the risk of death from severe malaria outweighs the theoretical risk to the foetus.
  3. Pregnant, first trimester, uncomplicated → Quinine + Clindamycin, three times daily for 7 days, with a warning to monitor for tinnitus and blood glucose (quinine can cause hypoglycaemia in pregnancy).
  4. Uncomplicated, first-line contraindicated → Artesunate-Amodiaquine (ASAQ), once daily for 3 days, weight-banded.
  5. Uncomplicated, standard case (including pregnancy T2/T3, which follows the same regimen as non-pregnant patients) → Artemether-Lumefantrine (AL), twice daily for 3 days — 6 doses total, weight-banded, with a day-by-day schedule (dose 1 at 0 hours, dose 2 at 8 hours, then morning/evening on days 2 and 3).

Every regimen includes the exact tablet count for the patient's weight band, a day-by-day schedule you can hand to the patient or caregiver, and the specific STG 2022 chapter reference behind it.

G6PD handling

  • Deficient: primaquine is flagged as contraindicated — the tool will not add it for radical cure or gametocyte clearance.
  • Unknown: a warning to hold primaquine until G6PD testing is performed, rather than assuming it's safe.

Severe malaria in any patient — pregnant or not — is treated as a medical emergency requiring hospital admission. This tool gives you the correct regimen and schedule; it doesn't replace the admission itself.

Reference

Nigeria STG 2022, Chapter 5.