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ObjectivePlasmodium 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 WHO guidelines for the treatment of Plasmodium falciparum infections.MethodsReview. 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 March 1st , 2021.ResultsThirteen 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.ConclusionTreatment 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

Tropical medicine & international health : TM & IH

Publication Date

03/01/2022

Addresses

Amsterdam University Medical Centers, University of Amsterdam, The Netherlands.