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1. Malaria is caused by a protozoan parasite of the Plasmodium genus, transmitted by mosquitoes.
2. There are five species of Plasmodium that regularly infect humans; Plasmodium falciparum is responsible for the vast majority of malarial deaths.
3. Severe malaria is a medical emergency, with mortality from untreated disease (particularly cerebral malaria) approaching 100 per cent. Early diagnosis and prompt, effective treatment are essential.
4. Parenteral artesunate is the treatment of choice for all severe malaria.
5. It is important to remember there are many causes of critical illness in the returning traveller, with a wide number of differentials, including, but not limited to: enteric fever (typhoid and paratyphoid), hepatitis, dengue or other arboviruses, avian influenza and viral haemorrhagic fever.
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