Evidence-based dosing for uncomplicated and severe malaria. WHO AFRO & SEARO guidelines. Optimised for Nigeria, Kenya, Ghana, Uganda, and India.
WHO Guidelines 2022Weight-based DosingPaediatric & Adult
For qualified clinicians only. Always verify doses against current national treatment guidelines and individual patient factors. This tool does not replace clinical judgment. Report any discrepancy using the flag button below.
Malaria remains the leading cause of morbidity and mortality in sub-Saharan Africa, responsible for over 608,000 deaths in 2021 (WHO World Malaria Report 2022) — the majority in children under 5. Nigeria alone accounts for approximately 27% of global malaria cases and 31% of global malaria deaths. Prompt, weight-appropriate treatment with the correct ACT is critical to reducing mortality and preventing spread of artemisinin partial resistance, which has now been confirmed in Rwanda, Uganda and several East African countries. This calculator reflects WHO 2022 malaria treatment guidelines with national protocol selection for Nigeria (NMEP), Kenya (NMCP), Ghana (NMCP), Uganda and Tanzania.
Frequently Asked Questions
Artemisinin partial resistance (ART-R), caused by mutations in the Pfkelch13 gene, has emerged in East Africa (Uganda, Rwanda, Tanzania). As of 2025, it has not been confirmed in Nigeria or West Africa, but surveillance is ongoing. ACTs remain highly effective in Nigeria when taken correctly for the full 3-day course.
IV artesunate is indicated for severe malaria: impaired consciousness (including prostration), repeated vomiting, respiratory distress, haemoglobinuria, severe anaemia (Hb <7 g/dL), hyperparasitaemia (>5%), hypoglycaemia, or circulatory collapse. Give a minimum of 3 IV doses before switching to oral ACT.
WHO recommends a single low dose of primaquine (0.25 mg/kg) with ACT for uncomplicated P. falciparum malaria as a gametocidal agent to reduce transmission. This is safe in most patients including G6PD-normal individuals. G6PD testing is recommended where available before giving primaquine.
If IV artesunate is unavailable, artesunate suppositories (rectal artesunate) at 10 mg/kg should be given as a single pre-referral dose and the patient transferred immediately to a higher facility for definitive IV treatment. If artesunate suppositories are also unavailable, intramuscular artemether (3.2 mg/kg loading dose, then 1.6 mg/kg daily) is an acceptable alternative. Quinine IV is the last-resort option. Oral ACTs must never be used in severe malaria.
Artemether-lumefantrine is currently recommended by WHO and FMOH Nigeria as the treatment of choice for uncomplicated malaria in all trimesters including the first. Previously, quinine plus clindamycin was preferred in the first trimester due to limited data on artemisinins, but updated WHO 2022 guidelines conclude the benefit of ACT outweighs the theoretical risk. For severe malaria in pregnancy, IV artesunate is used in all trimesters. Always document gestational age and consult obstetric and infectious disease colleagues in complex cases.
Related calculators
For weight-band ACT dosing tables (artemether-lumefantrine and DHA-piperaquine), see the dedicated ACT Malaria Dose 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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