Printed version of these guidelines

This guildelines are also available as a printed version: The white book can be purchased at the secretary of the department of pediatrics at the Queen Elizabeth Central Hospital in Blantyre, Malawi.


In 2004 Rebecca Sinfield co-ordinated the first edition of this protocol, but, as she anticipated then, time passes and medicine develops, so updating has to take place from time to time. The second edition was created in 2011. Now, in 2017, a third edition has been done.
This, currently electronic, version is in ongoing development containing some updated and some older chapters.
We can never rely on old knowledge, and the pace of change is quick. The protocols incorporate all the current practice and advice - but be aware that especially the older chapters might have changed by now - communicate with your colleagues! The aim is to make sure that – principally - interns, but also more experienced practitioners, can treat and care for Malawi’s most common paediatric conditions.
Otherwise experienced newcomers to Malawi may not previously have come across some of those illnesses, so the protocols should help us all to provide a level standard of care to all children seen in the department.


There will be future editions, with changes based on your experiences. Please always remember that your feedback is vital - for those future editions, but also for your patients and colleagues.
If at any time you feel a protocol doesn’t work, something is just plain wrong, or if you think you can change it for the better, please share it with us and help our work continue to improve.
In any enquires please contact Sara Loetz via email:


Thanks are still due to the doctors who prepared drafts for the original edition, and now to current members of the department who have revised and helped update these protocols. Your time is precious and there’s not a lot left for this type of exercise. Your contributions have been invaluable, not only the written ones, but also all the comments made during the discussion rounds of each chapter. We hope this revised set of protocols will be as useful as the first edition and will develop further.
Good luck, and thank you.

Sarah Konopelska, Kostas Karampatsas and Sara Loetz
in the name of the whole QECH paediatric department July 2017

Contributing authors

in alphabetical order

Dr. Tim Baker - Mechanical Ventilation
Dr. Jes Bates - The swollen joint
Dr. Rosalie Bartels - Malnutrition chapter
Dr. Takondwa Chimowa - Support services chapter
Dr. Carmen Gonzalez - HIV chapter
Dr. Ulla Hemmila - Nephrology chapter
Dr. Caroline Harris - Gastroenterology chapter
Dr. Anneka Hooft - Pneumonia, bronchiolitis
Dr. Kostas Karampatsas - Immunisations, pain management, tetanus, the swollen joint
Dr. Neil Kennedy - Cardiology chapter, haematology chapter, child sexual abuse
Dr. Sarah Konopelska - Malaria, asthma, general information, formulary, support services
Dr. Josephine Langton - Emergency chapter, gastroenterology chapter
Dr. Jennifer Lemon - The limping child
Dr. Sara Loetz - Formulary, CP, epilepsy, schistosomiasis, oncology
Dr. Mac Mallewa - Rabies, status epilepticus, neurology chapter
Dr. Bernadette O'Hare - TB chapter
Dr. Franziska Olgemöller - Thypoid and NTS sepsis, schistosomiasis
Dr. Ethwako Phiri - Neonatology chapter
Dr. Wieger Voskuijl - Malnutrition chapter

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