Malaria: prevention in travellers (non-drug interventions)

Malaria transmission occurs most frequently in environments with humidity greater than 60% and ambient temperature of 25°C to 30°C. Risks increase with longer visits and depend on activity. Infection can follow a single mosquito bite. Incubation is usually 10 to 14 days but can be up to 18 months, depending on the strain of parasite.

We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug interventions to prevent malaria in non-pregnant adult travellers? What are the effects of non-drug interventions to prevent malaria in child travellers and in pregnant travellers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2013 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations, such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

We found five studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

In this systematic review we present information relating to the effectiveness and safety of the following interventions: aerosol insecticides, air conditioning and electric fans, bath or chemical-base oils, biological control measures, dietary supplementation, electronic mosquito repellents, insecticide-treated clothing/nets, lifestyle changes (full-length and light-coloured clothing, behaviour modification), mosquito coils and vapourising mats, skin-applied chemical repellents (containing diethyltoluamide [DEET] or picaridin), skin-applied plant-based repellents, and smoke.