Intended for healthcare professionals

Practice 10-Minute Consultation


BMJ 2011; 342 doi: (Published 15 March 2011) Cite this as: BMJ 2011;342:d1149
  1. Deen M Mirza, assistant professor1,
  2. Muhammad Jawad Hashim, assistant professor1,
  3. Aziz Sheikh, professor of primary care research and development2
  1. 1Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, PO Box 17666, United Arab Emirates
  2. 2Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
  1. Correspondence to: D M Mirza deenmirza{at}
  • Accepted 9 November 2010

A 30 year old pregnant woman going home on holiday to Nigeria attends the clinic to get a prescription for malaria prevention tablets for herself and her two children.

What you should cover

Malaria is a potentially life threatening but preventable infectious tropical disease, caused by the Plasmodium parasite and transmitted by the Anopheles mosquito.

  • Ask what type and duration of holiday they plan—Sub-Saharan Africa is endemic for the most severe form of malaria, caused by Plasmodium falciparum. Risk increases in rural regions, with high humidity (such as during monsoon season), and with length of stay in the endemic region.

  • Explore health beliefs about immunity to malaria—People who have survived childhood in malaria endemic regions usually have developed immunity. However, patients who migrate to non-endemic areas often believe that they are still immune although this type of immunity declines in the absence of regular exposure.

  • Advise on the complications of malaria in pregnant women and in children—P falciparum malaria in pregnant women can cause severe complications such as miscarriage and prematurity, and can increase maternal morbidity and mortality. Children are at risk of serious complications such as hypoglycaemia and cerebral …

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