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Plasmodium falciparum is the most common species to result in severe malaria infection. Examination of blood sample with thick and thin smear is the gold standard diagnostic test and repeat peripheral smear monitoring every 12–24 h should be performed after initiation of treatment to ensure parasite clearance in severe infection. Treatment for severe P. falciparum infection should be initiated without delay, and if artemisinin products are not available, atovaquone-proguanil can be used as an alternative.