Proposed guidelines for severe imported malaria in children need more evidence

doi:10.1136/bmj.331.7523.1025-a

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Shamez Ladhani, research fellow, paediatric infectious diseases,
Delane Shingadia, senior lecturer, paediatric infectious diseases,
F Andrew I Riordan, consultant, paediatric infectious diseases and immunology

Academic Centre for Child Health, Royal London Hospital, London El 2AX
Royal Liverpool Children's Hospital (Alder Hey), Eaton Road, Liverpool L12 2AP

EDITOR—The proposed UK guidelines for severe childhood malaria are an excellent attempt to improve the care of children with severe imported malaria,1 but we are concerned about the following.

Firstly, the use of parenteral antibiotics. The “high risk group” would include less than 5% of children with imported malaria.2 Children with these features in the United Kingdom are likely to have bacterial septic shock or meningitis, …