New therapies and changing patterns of treatment for malaria.

The launch of the Roll Back Malaria initiative by the World Health Organization in the period under review confirms malaria's place as one of the great public health priorities worldwide. The period 1998-1999 has seen some advances and some disappointments in the treatment of malaria, against a backdrop of spreading drug resistance. Most encouraging is the clear demonstration that intermittent prospective treatment of asymptomatic pregnant women in endemic areas reduces morbidity. The greatest disappointment has been the result of trials with the artemether-benflumetol fixed-dose combination therapy. Questions have been raised about several widely accepted practices, including measurement of quinine levels, exchange transfusion, and the prophylactic use of anticonvulsants in children with cerebral malaria.