Management of Severe Imported Malaria in Adults

Abstract

In France, severe imported malaria concerns around 12–14% of the malaria episodes, mainly due to Plasmodium falciparum. From the WHO definition of severe malaria in endemic areas, the French definition of severe imported malaria has been elaborated considering an European context. Severe malaria is a diagnostic and therapeutic emergency and the initial management must be conducted in intensive care unit. The curative treatment of severe malaria is based on intravenous artesunate, which now must be available everywhere in France. Consequently, intravenous quinine is a second line treatment, with some residual indications. Management of organ dysfunctions in intensive care unit remains crucial, particularly during the most severe forms of imported malaria. Currently, no adjunctive therapy has proved its effectiveness in clinical practice.