1995•BMJOpen access

Fortnightly Review: Malaria prophylaxis: guidelines for travellers from Britain

David J Bradley, David C. Warhurst

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Abstract

Summary points Travellers to malarious areas must avoid mosquito bites, take chemoprophylaxis, and urgently seek early diagnosis and treatment for febrile illness The key to preventing malaria is avoiding infective mosquito bites by using repellents, covering up at night, and sleeping with bednets if mosquitos cannot be excluded from the room Appropriate chemoprophylaxis is essential when travelling to endemic areas—drug resistance is increasing in many areas so recommended regimens have changed Doses and choice of drug may have to be altered in those with concomitant illness Standby treatment may be given to those who will be unable to reach medical services for extended periods No prophylaxis is infallible so all fever and flu-like illnesses occurring within a year of returning from malarious regions need to be urgently investigated with malaria in mind

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Summary points Travellers to malarious areas must avoid mosquito bites, take chemoprophylaxis, and urgently seek early diagnosis and treatment for febrile illness The key to preventing malaria is avoiding infective mosquito bites by using repellents, covering up at night, and sleeping with bednets if mosquitos cannot be excluded from the room Appropriate chemoprophylaxis is essential when travelling to endemic areas—drug resistance is increasing in many areas so recommended regimens have changed Doses and choice of drug may have to be altered in those with concomitant illness Standby treatment may be given to those who will be unable to reach medical services for extended periods No prophylaxis is infallible so all fever and flu-like illnesses occurring within a year of returning from malarious regions need to be urgently investigated with malaria in mind

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Available abstract

Summary points Travellers to malarious areas must avoid mosquito bites, take chemoprophylaxis, and urgently seek early diagnosis and treatment for febrile illness The key to preventing malaria is avoiding infective mosquito bites by using repellents, covering up at night, and sleeping with bednets if mosquitos cannot be excluded from the room Appropriate chemoprophylaxis is essential when travelling to endemic areas—drug resistance is increasing in many areas so recommended regimens have changed Doses and choice of drug may have to be altered in those with concomitant illness Standby treatment may be given to those who will be unable to reach medical services for extended periods No prophylaxis is infallible so all fever and flu-like illnesses occurring within a year of returning from malarious regions need to be urgently investigated with malaria in mind

Key concepts: Chemoprophylaxis, Malaria, Malaria prophylaxis, Medicine, Primaquine, Intensive care medicine, Environmental health, Chloroquine

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