The past decade has seen an unprecedented surge in political commitment and international funding for
malaria control. Coverage with existing control methods (ie, vector control and
artemisinin-based combination
therapy) is increasing, and, in some Asian and African countries, childhood morbidity and mortality from
malaria caused by Plasmodium falciparum are starting to decline. Consequently, there is now renewed interest in the possibility of
malaria elimination. But the ability of the parasite to develop resistance to
antimalarial drugs and increasing insecticide resistance of the vector threaten to reduce and even reverse current gains. Plasmodium vivax, with its dormant liver stage, will be particularly difficult to eliminate, and access to effective and affordable treatment at community level is a key challenge. New drugs and
insecticides are needed urgently, while use of an effective
vaccine as part of national
malaria control programmes remains an elusive goal. This Seminar, which is aimed at clinicians who manage children with
malaria, especially in resource-poor settings, discusses present knowledge and controversies in relation to the epidemiology, pathophysiology, diagnosis, treatment, and prevention of
malaria in children.