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Malaria — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsMalariaSCE Infectious Diseases

A 45-year-old woman is admitted with P. falciparum malaria from Uganda. Parasitaemia is 12%, she is obtunded (GCS 12), creatinine is 320 µmol/L, glucose 2.8 mmol/L, and pH 7.28. Which treatment should be started immediately?

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Correct answer: A — IV Artesunate 2.4 mg/kg at 0, 12, 24 hours then daily

This is severe falciparum malaria (parasitaemia >10%, impaired consciousness, AKI, hypoglycaemia, metabolic acidosis). IV Artesunate 2.4 mg/kg is the treatment of choice, given at 0, 12, and 24 hours, then daily until the patient can take oral medication. It is superior to IV Quinine in reducing mortality. IV Quinine is an alternative only if Artesunate is not immediately available. Haemoglobin should be checked at day 14 as post-artesunate delayed haemolysis occurs in 10–15% of patients.

Reference: UKHSA/UKMEAG 2016 – UK malaria treatment guidelines; WHO 2022 – Guidelines for malaria