•If available, perform a rapid test to confirm presence of malaria. •Give first dose of artesunate for severe malaria.a •Give first dose of an appropriate antibiotic. •Treat the child to prevent low blood sugar. •Give one dose of paracetamol or ibuprofen in clinic for high fever (≥38.5 °C). •Refer urgently to hospital. If the child is unstable or at risk of imminent deterioration consider transferring them by ambulance.

^aThe dose of artesunate is 3 mg/kg for children with body weight < 20 kg and 2.4 mg/kg for children with body weight ≥ 20 kg, administered by intramuscular injection. Where artesunate is unavailable, artemether or quinine may be used [61].