Malaria treatment: what works, what to expect

Malaria can be treated effectively if caught early. The right drug depends on the parasite type, how sick you are, and where you got infected. This page gives clear, practical steps: how malaria is diagnosed, which medicines doctors use, what to do in severe cases, and simple prevention tips.

Common drugs and how they're used

For most uncomplicated falciparum malaria, doctors use artemisinin-based combination therapies (ACTs). Examples you’ll hear about are artemether-lumefantrine and dihydroartemisinin–piperaquine. Take the full course exactly as prescribed — stopping early can cause treatment failure and resistance.

If the infection is severe (very high fever, confusion, difficulty breathing, low urine output, or vomiting everything), intravenous artesunate in hospital is the standard. Severe malaria is life-threatening — immediate hospital care saves lives.

P. vivax and P. ovale need two steps: clear the blood infection with an antimalarial, then kill hidden liver stages (hypnozoites) with primaquine or tafenoquine to prevent relapses. Before using those drugs, you must test for G6PD deficiency because they can cause dangerous anemia in people with G6PD problems.

Some older drugs (like chloroquine) still work in places where parasites are sensitive, but resistance patterns change by region. That’s why clinicians pick drugs based on where you were infected.

Testing, prevention, and when to get urgent care

Don’t guess. If you have fever after travel to a malaria area, get tested right away. Rapid diagnostic tests (RDTs) and blood smears under a microscope are the common tests. A negative test with ongoing fever may need a repeat test — early infections can be missed.

Travelers can prevent malaria with three main prophylaxis choices: atovaquone–proguanil (daily), doxycycline (daily), or mefloquine (weekly). Which one suits you depends on destination, allergies, and side effects. Talk to a travel clinic for current local advice.

Simple bite prevention helps a lot: use 20–50% DEET repellent, sleep under insecticide-treated nets, wear long sleeves in the evening, and close windows or use screens. Small habits cut your risk.

Seek urgent care immediately if you have high fever and any of these after travel: confusion, breathlessness, passing little urine, severe vomiting, bleeding, or collapse. Also get help if symptoms don’t improve within 48 hours of starting treatment.

Drug resistance is a real issue in parts of Southeast Asia and some other regions. That means treatment choices can change. Always get local guidance and follow your clinician’s instructions. If you can, keep copies of your travel stops and any previous malaria treatment — it helps clinicians pick the best drug quickly.

Want quick next steps? If you or someone you know has fever after travel: test now, start care fast if positive, follow the full drug course, and use prevention to avoid another attack.