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Malaria — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsMalariaSCE Infectious Diseases

A 38-year-old man returns to the tropical medicine unit 10 days after a trip to Nigeria with a 3-day history of fever (40.1°C), rigors, headache, and myalgia. A thick blood film shows Plasmodium falciparum with 3% parasitaemia. He is conscious, orientated, and able to take oral medication. His SpO2 is 97%, BP 125/78 mmHg, and glucose 5.8 mmol/L. What is the most appropriate treatment?

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Correct answer: A — Artemether/Lumefantrine (Riamet) oral for 3 days

This is uncomplicated P. falciparum malaria (<2% parasitaemia without WHO severity features though parasitaemia is 3%). UK malaria treatment guidelines (UKMEAG 2016/UKHSA) recommend artemisinin-based combination therapy (ACT) as first-line for uncomplicated falciparum malaria. Artemether/Lumefantrine (Riamet) is the recommended first-line oral ACT. IV Artesunate is reserved for severe malaria (parasitaemia ≥2% with complications, or >10%, or any WHO severity criteria). At 3% parasitaemia without other severity criteria this patient can be managed orally but should be closely monitored. Chloroquine is ineffective against P. falciparum from sub-Saharan Africa.

Reference: UKHSA/UKMEAG 2016 – UK malaria treatment guidelines; UKHSA 2024 – Malaria updates