Chloroquine-resistant falciparum malaria — DTM&H MCQ

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ModerateMalariaChloroquine-resistant falciparum malariaDTM&H

A 19-year-old returns from western Kenya with fever and Plasmodium falciparum on blood film. He took no prophylaxis and asks whether chloroquine is sufficient because it helped a relative years earlier. What is the most appropriate treatment?

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Correct answer: A — Artemisinin-based combination therapy

Artemisinin-based combination therapy is the single best answer because falciparum malaria acquired in much of Africa is chloroquine-resistant and requires an effective combination regimen. Chloroquine monotherapy is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that primaquine is not a blood-stage treatment for falciparum malaria in this scenario.

Reference: WHO Guidelines for malaria, 2025; UKHSA Malaria prevention guidelines for travellers from the UK, 2025; CDC Yellow Book 2026