XVIII · Take-home messages
Severe Falciparum Malaria18 / 18
What matters.
01
Think malaria
Every febrile returned traveller — especially sub-Saharan Africa
02
Diagnose rapidly
Thick/thin films · RDT · PCR — treat on strong clinical suspicion
03
Start artesunate immediately
Do not delay. Do not use quinine first-line.
04
Organ support saves lives
ICU management prevents death — the drug clears the parasite
05
Recovery ≠ discharge
Monitor delayed haemolysis × 4 weeks post-artesunate
Key references
AQUAMATDondorp et al. Lancet 2010;376:1647–57 — artesunate vs quinine
SEAQUAMATDondorp et al. Lancet 2005;366:717–25 — first adult evidence
WHO 2024Living guideline — current treatment recommendations
FEASTMaitland et al. NEJM 2011;364:2483–95 — fluid bolus harm
Marks et al.Br J Anaesth 2014;113(6):910–921 — managing malaria in ICU
Riddle et al.Clin Infect Dis 2002;34:1192–8 — exchange transfusion meta
Presenter
Dr Timothy Chimunda FCICM
Clinical Director ICU · NWRH  ·  Innovate Critical Care Consultancy
CICM Fellowship Masterclass · 2026Dr Timothy Chimunda FCICM
Take-Home + References18 / 18
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