once almost eliminated from Madagascar, malaria has returned to stay with the development of insecticide-resistant mosquitos and drug-resistant strains of malaria. In the meantime, the population increased 4-fold, and the resulting deforestation and growth of rice paddies greatly enlarged the range of mosquito vectors. In the 1980s, some 6% of Western travellers who contracted malaria died of it world wide, so the risk is not small and is increasing. 100,000 highland Malagasy died of malaria in 1988, when Anopheles funestus made its reappearance. Quinine is a better prophylactic than chloroquine, but travellers are advized to check with the Malaria Reference Laboratory (London) or its equivalent elsewhere to learn the latest recommendations for this rapidly changing problem. One starts taking pills some weeks before the trip, and continues even longer afterwards.