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Malaria — RACP Paediatrics MCQ

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HardInfectious DiseaseMalariaRACP Paediatrics

An 8-year-old boy from Sub-Saharan Africa presents to an Australian emergency department with cyclical fevers every 48 hours, rigors, headache, and splenomegaly. A blood film shows ring-form trophozoites within red blood cells with >5% parasitaemia. What is the most appropriate treatment?

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Correct answer: E — IV artesunate

Severe malaria (parasitaemia >2%, signs of end-organ dysfunction, or any falciparum malaria with high parasite load) requires IV artesunate as first-line treatment. >5% parasitaemia indicates severe disease. Chloroquine resistance is widespread in P. falciparum from Sub-Saharan Africa. Oral therapies are only appropriate for uncomplicated malaria.

Reference: Therapeutic Guidelines – 2024 – Antibiotic: Malaria