Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

OBJECTIVE: Plasmodium falciparum infections are a relatively rare but potentially deadly disease found in returning travellers. We compare the national treatment guidelines of non-endemic countries with the WHO guidelines for the treatment of Plasmodium falciparum infections. METHODS: Review. We identified non-endemic countries with an incidence rate of imported malaria of at least one per 100,000 population and at least 50 cases annually. Using PubMed and Google Search, we reviewed national guidelines published before 1 March 2021. RESULTS: Thirteen guidelines were identified. For uncomplicated falciparum malaria, 11 of 13 countries (85%) recommend an artemisinin-based combination therapy as first-line regimen in adults, of which artemether-lumefantrine was the most common. For severe malaria, all guidelines recommend the use of intravenous artesunate. Only three countries adjust treatment recommendations based on expected artemisinin resistance. CONCLUSION: Treatment guidelines for uncomplicated falciparum malaria in non-endemic countries generally adhere to WHO recommendations but often fail to mention the risk of drug resistance in returning travellers. Artemisinin-based Combination Therapies (ACTs) should be the first choice for all uncomplicated malaria cases. Furthermore, the choice between ACTs should be based on regional resistance patterns.

Original publication

DOI

10.1111/tmi.13715

Type

Journal article

Journal

Trop Med Int Health

Publication Date

02/2022

Volume

27

Pages

129 - 136

Keywords

WHO, guidelines, malaria, review, treatment, Antimalarials, Artemether, Lumefantrine Drug Combination, Artesunate, Drug Resistance, Guidelines as Topic, Humans, Malaria, Falciparum, World Health Organization