Malaria in Children

Introduction

Malaria in the newborn babies presents as sepsis in most instances as the clinical features are very similar.

Investigations

  • Rapid Diagnostic Tests for rapid detection of Plasmodium falciparum in situations of poor laboratory services
  • Peripheral blood film microscopy with Giemsa staining which most frequently reveals Plasmodium falciparum.
  • Full blood count: anaemia and
    leucocytosis.
  • Blood culture is expected to be negative.

Management of malaria in children

Every symptomatic infant and asymptomatic infants in whom parasitaemia persists beyond 72 hours of life should be treated.
Due to the extreme similarities in the clinical manifestations of malaria and sepsis in the newborn, it may be safer to start acutely ill babies with probable malaria on anti-malarial drugs as well as antibiotics until sepsis could be confidently excluded.

  • Oral quinine 20mg/kg stat, followed with 10mg/kg 8 hourly for 5 to 7 days is recommended.
  • Oral amodiaquine as 25mg/kg total
    dose administered as 10mg/kg/day
    on the first two days and 5mg/kg on
    the third day may be used when
    quinine is contraindicated.

In areas of high resistance to the 4- aminoquinolines, amodiaquine may not be useful.
Treat infants weighing <5 kg with
uncomplicated P. falciparum malaria with ACT at the same mg/kg body weight target dose as for children weighing 5kg with close monitoring of response.