title: [Malaria and children who travel - prophylaxis and therapy].
abstract: Children account for between 15 - 20 % of all imported malaria cases worldwide. Immigrant children visiting their families in the country of origin in sub-Saharan Africa are at highest risk. Prevention of malaria in children who travel to endemic areas is guided by the ABCD principles - Awareness of risk, Bite prevention, Chemoprophylaxis for high risk areas and rapid Diagnosis and treatment when malaria is suspected. The use of anti-malarial medication in small children is hampered by a paucity of dosage, pharmcokinetic and tolerability data. In the pre-travel consultation parents should be provided with practical advice on anti-mosquito measures, exact, (weight-based) dosages of chemoprophylaxis medication and/or stand-by treatment as indicated. A paediatric formulation is available for daily atovaquone-proguanil chemoprophylaxis (children > 11 kg) and mefloquine is a cost-effective, once weekly prophylaxis that is useful for children > 5 kg who travel for longer periods. The bitter taste of mefloquine should be disguised to increase adherence. When a Stand-by Emergency Treatment (SBET) is indicated, artemether-lumefantrine cherry flavoured dispersible tablets are a good choice for small children. Post-travel to endemic areas, malaria should always be suspected if a child becomes ill. Paediatric malaria is an emergency requiring prompt diagnosis and appropriate treatment.
authors.affiliation: Zentrum für Reisemedizin, Institut für Sozial- und Präventivmedizin, World Health Organization, Collaborating Centre for Travellers' Health, Universität Zürich. pat@ifspm.uzh.ch
authors.forename: Patricia
authors.initials: P
authors.lastname: Schlagenhauf
authors.forename: Sabine
authors.initials: S
authors.lastname: Haller
authors.forename: Noémie
authors.initials: N
authors.lastname: Wagner
authors.forename: François
authors.initials: F
authors.lastname: Chappuis
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002669:Child Welfare / Q000639:trends*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000188:drug therapy* / Q000517:prevention & control*; D008297:Male; D013557:Switzerland; D014195:Travel; D057236:Travel Medicine / Q000639:trends*
chemical_list: D000962:Antimalarials