Malaria. The latest in advice for travellers

Malaria prevention in travellers is typically the most complex travel health issue faced by practitioners. Approximately 300 to 500 million people in the world are infected with malaria and between 1.5 and 2.7 million people die from it every year. Although the disease is mainly confined to the tropical areas of Africa, Asia and Latin America, it remains a serious and worsening health problem.

In this article recommendations are provided to assist doctors giving advice to travellers visiting regions where malaria is endemic. The focus is on prophylactic medications and self treatment regimens.

Advice to travellers should include information on the need for prompt diagnosis and treatment of febrile illness, on minimising exposure to mosquitoes, and the use of repellents and contact insecticides. A simplified chemoprophylaxis regimen is chloroquine for chloroquine sensitive malaria areas, mefloquine or doxycycline for areas with chloroquine resistant malaria and doxycycline for areas with mefloquine resistant malaria. With the advent of new self treatment regimens and 'in the field' rapid diagnostic tests, self treatment has become a reasonable option in certain circumstances.