Malaria - Prevention 

The risk of malaria for people travelling to affected areas is significant, so it is important to take precautions to prevent it.

Approximately 1,500 travellers return to the UK with malaria every year. Most of the malaria imported to the UK is caused by plasmodium falciparum and is acquired in Africa.

Many cases of malaria can be prevented by the ABCD approach:

• Awareness of risk: know your risk of malaria.
• Bite prevention: avoid bites as much as possible.
• Chemoprophylaxis: take the right antimalarial tablets.
• Diagnosis: get immediate medical help for symptoms.

Awareness of the risks

You can check whether you need to take preventative malaria treatment for the country that you are visiting by looking at the Fit for Travel or NaTHNaC websites.

Visit your GP or local travel clinic for advice on malaria and other health risks as soon as you know that you are going to be travelling.

Bite avoidance

While you will not be able to avoid bites completely, the less you and your family are bitten, the less likely you are to catch malaria. Below are a number of things you can do to help prevent being bitten by mosquitoes:

• Ideally, stay somewhere with effective air conditioning and screening on doors and windows. If this is not possible, try to stay somewhere with doors and windows that close.
• If you are not sleeping in an air-conditioned room or if the air-conditioning is not effective, you must sleep under an intact mosquito net that has been treated with insecticide.
• Use insect repellent on your skin and in sleeping environments. Remember to reapply frequently.
• The most effective repellents contain diethyltoluamide (DEET) and are available in sprays, roll-ons, sticks and creams.
• Wear light, loose-fitting trousers, rather than shorts, and shirts that have long sleeves. This is particularly important during early evening and at night, as this is the mosquito’s preferred feeding time.

Garlic, vitamin B and ultrasound devices do not prevent bites.

Chemoprophylaxis: taking appropriate antimalarial tablets

Taking medicine to prevent catching malaria is essential for all travellers who are visiting areas with malaria. However, antimalarials are not 100% effective, so avoiding bites is also important.

Taking antimalarial medicine:

• Make sure you get the right antimalarial tablets before you go.
• You will have to pay for your antimalarials, so include the cost in your trip budget.
• Follow the instructions included with your tablets carefully.
• It is important that you continue to take your tablets after you return from your trip. This is to cover the incubation period of the disease.
• Most tablets need to be taken for four weeks after you return, although atovaquone plus proguanil (Malarone) needs to be taken for only one week.

Talk to your doctor to make sure that you are prescribed a drug you can tolerate. You may be more at risk from side effects if you have:

• AIDS/HIV
• epilepsy or any type of seizure
• depression
• heart problems
• liver or kidney disease
• porphyria (an inherited condition that causes sensitivity to sunlight)
• psoriasis
• psychiatric problems

You may also be more at risk from side effects if: 

• your spleen has been removed or does not work properly
• you take medicine (such as warfarin) to prevent blood clots
• you are a woman using combined hormonal contraception, such as the pill or patches

If you have taken antimalarial medicine in the past, do not assume that it is suitable for future trips. The medicine you need to take depends on the strain of malaria carried by the mosquitoes and drug resistance in the region that you are travelling to.

In Britain, chloroquine and proguanil can be brought from local pharmacies. For all other antimalarial tablets, you need a doctor's prescription.

Diagnosis: get prompt medical advice

If you become ill when you get back from travelling, even if you took the right malaria prevention tablets, you must see your GP or a hospital doctor straight away.

Tell the doctor that you have been exposed to malaria. It is important that you tell them which countries you have travelled to in the last 12 months, including brief stopovers.

Malaria can develop very quickly, so it is important to get medical advice, diagnosis and treatment as soon as possible if you think you may have malaria.