[Malaria in children in 1990].

The development of imported cases and the upsurge of resistance to chloroquine have altered the diagnosis and treatment of infantile malaria. The diagnosis may be missed, with a risk of the disease turning into a lethal attack of cerebral malaria. The demonstration of plasmodia in blood smears is the best proof of the disease, but waiting for it should not always delay treatment. Intravenous quinine remains the basic therapy of cerebral malaria. As the distribution of chloroquine-resistant strains is imperfectly known, the prophylaxis and treatment of simple attacks are often difficult. As regards curative therapy, halofantrine seems to be easier to handle than mefloquine, but it is useless for prevention. Preventive measures, including the use of mosquito nets and treatment of febrile episodes presumed to be malarial, are useful additions to the systematic prescription of drugs that are seldom fully effective.