Education And Debate

Fortnightly Review: Malaria prophylaxis: guidelines for travellers from Britain

BMJ 1995; 310 doi: (Published 18 March 1995) Cite this as: BMJ 1995;310:709
  1. David J Bradley, codirectora,
  2. David C Warhurst, codirectora a meeting convened by the Malaria Reference Laboratory
  1. a Malaria Reference Laboratory of the Public Health Laboratory Service, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  1. This report was prepared by Professor Bradley and Dr Warhurst on behalf of the committee listed in the appendix. Correspondence to: Professor Bradley.


    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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