Treating malaria in the UK

Imported malaria remains a significant cause of mortality and morbidity in children travelling to areas of the world endemic for malaria. Malaria is one of the commonest imported tropical diseases in the UK, with infection acquired most commonly in sub-Saharan Africa. Over 80% of all cases of malaria are due to Plasmodium falciparum, which can cause severe or life-threatening multi-organ disease in children. The clinical features of malaria in children are protean and often non-specific resulting in missed or delayed diagnosis. Children are more likely than adults to deteriorate rapidly and to develop severe malaria, particularly cerebral malaria. Malaria should be suspected in all children with a history of travel to a malaria endemic country who present with fever. Diagnosis is usually made with repeated thick and thin blood films. Delays in diagnosis are associated with an increased risk of developing severe malaria and death. Appropriate anti-malarial therapy and supportive care should be instituted as soon as possible, particularly in children with severe malaria. Advice should be sought early from an appropriate specialist.