Treatment and prevention of malaria in children.

Malaria is a tropical disease. However, due to travel, cases can be imported into countries with temperate climates. For instance there are 1300–1800 cases imported into the UK each year. Three-quarters of reported malaria cases are caused by Plasmodium falciparum , which is capable of causing severe or life-threatening disease. Roughly 10% of cases occur in children. Malaria in children often presents with misleading symptoms and the presentation of malaria can be delayed for many months. Therefore a travel history is important in all children presenting with fever. Awareness and early diagnosis using thick and thin blood films or rapid diagnostic tests is crucial in improving outcomes. Uncomplicated P. falciparum malaria should be treated with an artemisinin combination therapy (ACT), quinine with doxycycline or clindamycin, or atovaquone-proguanil. Severe or complicated malaria in children should be treated with intravenous artesunate or intravenous quinine if artesunate is not available. Children with severe malaria should be managed in a high-dependency or intensive care setting. Either an oral ACT or chloroquine can be used for the treatment of non-falciparum malaria. Dormant parasites (hypnozoites) may persist in the liver after treatment of P. vivax or P. ovale so primaquine may be required to prevent relapse. Prevention of malaria in children involves the use a combination of bite prevention strategies and chemoprophylaxis. Recent vaccine developments have seen WHO approving the malaria vaccine RTS,S/AS01 for prevention in children living in regions with high transmission in sub-Saharan countries. This short article gives practical advice to health care professionals caring for children who return from malaria endemic areas to countries where the condition is far less common. [ABSTRACT FROM AUTHOR]