[Malaria in the 21st century: clinical and therapeutic problems in imported malaria]

Imported malaria is an ever growing disease in our country because of the increase in travels to endemic tropical areas where this disease is endemic. Many patients, when they come to our hospitals infected with P. falciparum have already received drugs for this disease, either as prophylaxis or treatment, as it occurred in the cases reported here in the years 1995 and 1997, all of the spanish individuals who had travelled to or lived in African countries. To remark from our data the relevance of resistance to prophylactic and therapeutical agents in wide geographical areas, the frequent misuse of antimalarial drugs and complications that can emerge with the standard treatment for malaria. It all leads to the development of new therapeutic approaches for this potentially fatal infection. Based on the clinical efficiency in cases of politreated malaria cases, as well as for its safety in patients to whom first choice drugs cannot be administered (such as quinine), we stress the new therapy made up with the association atovaquone-proguanil.