Intravenous artesunate for imported malaria in pregnancy: two case reports

Introduction: Pregnant women have historically been underrepresented in clinical trials, resulting in limited evidence regarding malaria management in this population. This knowledge gap is particularly evident for imported malaria cases occurring in non-endemic regions. Case presentation: We describe two cases of imported Plasmodium falciparum malaria in pregnant women managed in a non-endemic setting. Both patients were successfully treated with intravenous artesunate, resulting in clinical recovery and parasite clearance. Both pregnancies resulted in favorable delivery outcomes, and no immediate neonatal adverse events were noted during the follow-up period. Conclusions: Timely diagnosis of imported malaria in pregnant women in non-endemic areas is essential, as it may be overlooked due to its low prevalence and unfamiliar clinical presentation. Clinicians should maintain a high index of suspicion and apply individualized treatment strategies according to clinical assessment and current guidelines to optimize maternal and fetal outcomes.