[Current malaria management in Switzerland].

Diagnosis and management of malaria in returning travellers must be treated as an emergency. A thorough travel history and a blood examination are prerequisites for diagnosis of the infection. Plasmodium vivax, P. ovale and P. malariae infections cause febrile illnesses that are usually not dangerous, but P. falciparum often causes complications that can be fatal. Hospitalization should therefore be considered in the latter cases. The clinical features of the disease are often non-specific (fever, headache, myalgia, sweating). Furthermore, mitigated and delayed courses of the illness due to sub-therapeutic antimalarial drug levels are recorded in patients who have taken incomplete chemosuppression. Chloroquine is still the treatment of choice in most cases of P. vivax, P. ovale and P. malariae infections. In P. falciparum malaria, chemoresistance in many parts of the world requires treatment with other antimalarials. Treatment should be started when there is strong suspicion of malaria even before the diagnosis is parasitologically confirmed. Quinine is the drug of choice in severe P. falciparum malaria. An intravenous loading dose is administered if no previous treatment has been given.