The main objective is to prevent the patient from dying, secondary objectives are prevention of recrudescence, transmission or emergence of resistance and prevention of disabilities.
The mortality of untreated severe malaria is thought to approach 100%. With anti-malarial treatment the mortality falls to 15-20% overall, although within the broad definition are syndromes associated with mortality rates that are lower (e.g. severe anaemia) and higher (metabolic acidosis). Death from severe malaria often occurs within hours of admission to hospital or clinic, and so it is essential that therapeutic concentrations of antimalarial are achieved as soon as possible.
Management of severe malaria comprises four main areas: clinical assessment of the patient, specific antimalarial treatment, adjunctive therapy and supportive care.