Management and prevention of imported malaria in children. 2019 update of the French guidelines

•The incidence of imported malaria in children has greatly decreased over the past 10years, but the proportion of severe presentations has increased. Imported malaria should be considered in children presenting with fever who have recently traveled to an endemic area. The diagnosis should be confirmed with a sensitive detection technique (thick blood smear or molecular biology technique with a rapid time to response) and with a blood film.•P. falciparum malaria requires the urgent administration of treatment and all children suspected of having imported malaria should be hospitalized to initiate treatment: children presenting with P. falciparum uncomplicated malaria should receive an artemisinin-based combination treatment (ACT: artemether-lumefantrine or artenimol-piperaquine), and children presenting with imported malaria caused by other Plasmodium species should receive chloroquine or an ACT. Treatment may be continued in an outpatient setting if specific criteria are met. Treatment of P. vivax or P. ovale malaria episodes requires the addition of primaquine to eradicate hypnozoites, unless contraindicated. The initial treatment of severe malaria is intravenous artesunate and should be administered in the intensive care unit or in a continuous monitoring unit.•The prevention of malaria is always based on the protection against Anopheles mosquito bites associated with a chemoprophylaxis, if required. Travelers should be informed about the risk of malaria upon return.