Malaria presenting in children in the UK – clinical features and management

Increased air travel to exotic destinations means increasing numbers of cases of malaria imported to the UK. The diagnosis needs to be considered early in those with symptoms who have recently visited an endemic area. The presentation is extremely variable and the risk of life-threatening complications high, close monitoring therefore as an inpatient is recommended while treatment is initiated. Treatment for severe malaria starts with intravenous quinine and courses can be completed with one of a choice of oral medications. Co-infection with bacteraemia is not uncommon and broad-spectrum antibiotics including gram negative coverage should be started in children with severe features while culture results are awaited.Currently uptake of prophylactic medication in travellers is poor and there needs to be a heightened awareness of the risks and recommendations amongst health professionals.