Preface

Malaria continues to be a major global health problem, with over 40 % of the world’s population - more than 2000 million people - exposed to varying degrees of malaria risk in some 100 countries. In addition, with modern rapid means of travel, large numbers of people from nonmalarious areas are being exposed to infection which may only seriously affect them after they have returned home

Plasmodium falciparum causes the most serious form of the disease, and is common in the tropics. Infections with this parasite can be fatal in the absence of prompt recognition of the disease and its complications, and active appropriate patient management. The situation is complicated by the increasing occurrence of P. falciparum parasites that are resistant to chloroquine and other antimalarial drugs. Prompt action is especially important for high-risk groups such as young children and pregnant women.

Because of the increasing seriousness of this problem, the World Health Organization invited Professor H. M. Gilles to prepare this aide-mémoire on the clinical diagnosis and management of severe malaria. It is intended primarily for physicians and other responsible health personnel working in hospitals, or health centres with inpatient facilities, in malarious areas of the world, but will also be of practical use to physicians in nonendemic countries.

This handbook is based on “Severe and complicated malaria”, edited by D. A. Warrell, M. E. Molyneux and P. F. Beales, and published in Transactions of the Royal Society of Tropical Medicine and Hygiene, 1990, 84 (Suppl 2). During the preparation of this guide, valuable advice was provided by a number of colleagues. Professor Gilles and the World Health Organization gratefully acknowledge the very willing collaboration and support given by Professor D. A. Warrell, Nuffield Department of Clinical Medicine, University of Oxford; Dr M. E. Molyneux, Liverpool School of Tropical Medicine; Professor Tan Chongsupphajaisiddhi, School of Tropical Medicine, Bangkok; Professor Khunying Tranachit Harinasuta, Bangkok; Professor Looareesuwan, Hospital for Tropical Diseases, Bangkok; Dr N. J. White, Wellcome-Mahidol University-Oxford Tropical Medical Research Programme; Dr A. P. Hall, Hospital for Tropical Diseases, London; Dr R. N. Davidson, Hospital for Tropical Diseases, London; and Dr P. F. Beales and Dr R. Kouznetsov, Training Unit, Division of Control of Tropical Diseases, World Health Organization, Geneva.