Under the WHO-recommended Integrated Management of Childhood Illness (IMCI), a child with malaria residing in high-transmission area and found to have axillary temperature ≥37.5°C should first receive:

• A Rapid diagnostic test (RDT) and treat only if positive with artemisinin-based combination therapy (ACT) ✓
• B IV quinine as first-line treatment pending blood smear results
• C Presumptive treatment with chloroquine regardless of test result
• D Paracetamol only and refer to hospital for parasitological diagnosis

Explanation

NVBDCP and WHO guidelines mandate test-and-treat: a RDT or microscopy must confirm malaria before treatment is initiated — presumptive treatment without testing is no longer recommended. If RDT is positive for P. falciparum, treat with ACT (Artemether-Lumefantrine in India); if P. vivax, treat with Chloroquine + Primaquine. This approach preserves ACT efficacy and avoids unnecessary drug pressure.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.