Imported malaria has become an increasingly significant cause of mortality and morbidity in children travelling to areas of the world endemic for malaria. Malaria is one of the commonest imported tropical diseases in the UK, with children accounting for 15–20% of all cases. Over 80% of all cases of malaria are due to Plasmodium falciparum infection, which can cause severe or life-threatening multi-organ disease in children. The clinical features of malaria in children are often non-specific, resulting in missed or delayed diagnosis. Children are more likely than adults to deteriorate rapidly and to develop severe malaria, particularly cerebral malaria. Malaria should be suspected in all children with a history of travel to a malaria-endemic country who present with fever. Diagnosis is usually made with repeated thick and thin blood films. Delays in diagnosis are associated with an increased risk of developing severe malaria and death. Appropriate antimalarial therapy and supportive care should be instituted as soon as possible, particularly in children with severe malaria. Advice should be sought from an appropriate specialist.
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