Artemether-lumefantrine and DHA-piperaquine dosing with country-specific first-line protocol guidance. Nigeria · Kenya · Ghana · Uganda · Tanzania · India.
WHO Guidelines 2022Country ProtocolsWeight-based DosingPaediatric & Adult
For qualified clinicians only. Country protocol recommendations reflect current national malaria treatment guidelines but may differ from individual facility or programme guidance. Always verify against your national treatment guidelines and patient-specific factors. Report any dosing discrepancy using the flag link below.
Artemisinin-based combination therapies (ACTs) are the WHO-recommended first-line treatment for uncomplicated Plasmodium falciparum malaria. Weight-based dosing is critical especially in children, where under- or over-dosing affects both efficacy and safety. Artemether-lumefantrine (Coartem) is the most widely used ACT across sub-Saharan Africa, while DHA-piperaquine (Eurartesim) is increasingly adopted in East Africa and parts of South Asia. This calculator reflects WHO 2022 malaria treatment guidelines and country-specific national protocols for Nigeria, Kenya, Ghana, Uganda, Tanzania and India. Always verify your country's current first-line recommendation — protocols may change with regional resistance surveillance data.
Frequently Asked Questions
Nigeria's National Malaria Elimination Programme (NMEP) recommends artemether-lumefantrine (AL) as first-line treatment for uncomplicated malaria in all age groups including pregnant women in the second and third trimester. DHA-piperaquine is used in some programmatic settings.
AL is given in fixed weight bands: 5–14 kg (1 tablet), 15–24 kg (2 tablets), 25–34 kg (3 tablets), ≥35 kg (4 tablets) — twice daily for 3 days (6 doses total). Each dose should be taken with food or a fatty drink to maximise absorption. Repeat the dose if vomiting occurs within 30 minutes.
Switch to IV artesunate for any sign of severe malaria: impaired consciousness, repeated vomiting, respiratory distress, haemoglobinuria, severe anaemia (Hb <7 g/dL), hyperparasitaemia (>5%), or inability to take oral medication. Do not give oral ACT in severe malaria.
AL is not recommended for infants weighing less than 5 kg due to insufficient safety and pharmacokinetic data. For infants under 5 kg with uncomplicated falciparum malaria, WHO guidelines recommend treating with artesunate suppositories as a pre-referral measure and transferring to a higher-level facility for IV artesunate. Seek specialist guidance in all cases.
If vomiting occurs within 30 minutes of an AL or DHA-piperaquine dose, repeat the full dose. If vomiting occurs between 30 and 60 minutes, repeat half the dose. If the child cannot retain any oral medication after two attempts, switch to IV artesunate or artesunate suppositories and refer. Always give AL with food or a fatty substance to reduce vomiting and improve absorption.
Related calculators
For IV artesunate dosing in severe malaria and primaquine radical cure dosing, see the Malaria Dosing Calculator.
📋 Guideline basis: WHO Malaria Guidelines 2022 · NMEP Nigeria 2020 · Last reviewed: January 2025 · Next review due: January 2026 · Disclaimer · Report an error
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