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Malaria

Note: Malaria maps and specific malaria advice for each country affected by malaria is available on the individual country pages

Introduction

Malaria is a serious parasite infection that is transmitted by the bite of female mosquitoes. The parasites are microscopic and found in the blood of infected people. There are different types of malaria parasite and although the infection they cause is similar. 'Falciparum' malaria is the one that causes the most severe infection.

  • Malaria can be deadly if untreated.

Symptoms of malaria:

  • usually include a high temperature (fever) accompanied by shivering and sweating
  • are often described as 'flu-like' and can be accompanied by a variety of other symptoms, such as muscle aches, headache or vomiting
  • can be vague, especially in children who may simply be 'out of sorts'

Malaria symptoms can quickly become severe if effective treatment is not started quickly.

You cannot be vaccinated against malaria, but you can protect yourself against this disease using the A, B, C, D approach to prevention as follows:

A = Awareness of risk

Malaria is widespread in many tropical and subtropical countries.

Be aware that the risk of malaria can vary within different parts of the same country, between neighbouring countries, and at different times of year.

Risk for travellers

Every person regardless of their origins who visits a country where malaria is present is at risk of catching malaria.

Increased risk of catching malaria
Some groups of people are at increased risk of catching malaria because of the type of travel they are undertaking. These groups include:

  • people who are travelling to visit friends or relatives
  • those planning a longer stay in rural areas 
  • longer term travellers to areas with malaria

Increased risk of developing severe malaria
There are also groups of people who are at an increased risk of developing severe malaria if they catch the infection. These include:

If you think you fall into any of these categories, you should see a travel health professional for a travel health risk assessment before you travel to a malaria-affected country:

  • they will advise you if you have an increased risk of catching malaria, or of developing serious malaria
  • you may need to take additional measures other than bite prevention to protect yourself, including taking tablets to prevent malaria, even if the risk of malaria is considered to be low

B = Bite Prevention

Protecting yourself against mosquito bites is essential.

  • Reducing the number of bites you receive reduces your chance of developing malaria.

Mosquitoes that transmit malaria typically bite at night, after sunset.

  • There are also day biting mosquitoes that transmit other potentially serious diseases, so make sure you protect yourself against mosquito bites at all times of the day and night.

Take practical measures to avoid mosquito bites including:

C = Chemoprophylaxis (taking malaria prevention tablets)

Find out the risk of malaria in the country you intend to visit by checking the malaria section on each country page.

  • The malaria section will indicate if you need to take tablets to prevent malaria (antimalarials). 

For countries with a high risk:

  • antimalarial tablets are recommended for everyone
  • bite prevention is recommended for everyone

For countries with a low risk with additional advice:

For countries with a low to no risk:

Protecting yourself against mosquito bites is as important as taking antimalarial tablets.  This is because:

  • no antimalarial tablets are 100% effective, but if you take these in addition to preventing mosquito bites, this will significantly reduce your chance of catching malaria
  • antimalarial tablets do not prevent malaria parasites entering your body, but they do help to stop the infection establishing and symptoms developing

There are a range of different types of antimalarial tablets available, and these differ in:

  • how they protect you against malaria
  • how they should be taken
  • their side effects
  • the places in the world where they can be used (because of drug resistance problems, which are different for different drugs)

It is important to discuss the suitability of antimalarial tablets for you with a qualified doctor, nurse or pharmacist.

  • This is to make sure that you can tolerate the recommended tablets and ensure that they are appropriate for your destination(s).

How to take antimalarial tablets:

You should begin taking antimalarial tablets before arriving in a malaria-risk area as guided by your travel health professional.

  • Some tablets need to start a few days before you travel, whilst others may need to be started a week or more before travel.
  • This means there will be enough antimalarial medication in your system to start preventing infection as soon you arrive in the country.

It is important to take the tablets regularly and as directed – missing tablets can lead to malaria infection.

  • It may be helpful to set an alarm to remind you when to take your tablets.

You must complete the course of tablets even after you have left the malaria area:

  • stopping a course of tablets early, even when you are no longer in a malaria area, can lead to you developing malaria infection if the parasites are already in your body
  • the length of time you have to keep taking the tablets after you leave the malarial area is different for different drugs, and you will be advised about this

In the UK, antimalarial tablets require a prescription, except for:

  • chloroquine, which can be bought from local pharmacies
  • Atovaquone/proguanil (often known as Malarone or Maloff protect) which can be bought from local pharmacies (with some restrictions)

Talk to a pharmacist or travel health professional if you are unsure which antimalarials are most suitable for you or your family.

Further information on the commonly used antimalarial drugs can be found via the following links:

D = Diagnosis and prompt treatment

Quick diagnosis and access to prompt treatment for malaria saves lives. The most serious forms of malaria can become life-threatening within 24 hours.

If you think you might have malaria it is very important to seek medical attention urgently.

  • Remember that the symptoms can be vague.
  • Infection can occasionally still develop even if you have taken antimalarial tablets.
  • The most serious form of malaria ('falciparum' malaria) can occur around 6 days after first entering a malaria area and up to 30 days (occasionally longer) after leaving a malaria area.
  • If in doubt, seek medical advice and seek it quickly.

Some types of malaria can develop many months after you have visited a malaria affected country:

  • if you develop a high temperature (fever) between 1 week after first potential exposure and up to 1 year after your return from a country with malaria, you should seek medical attention urgently and tell the doctor that you have been in a malaria risk area.

Emergency Standby Treatment for Malaria

If you are travelling to remote or rural areas of a malaria-risk country where you will be unable to access medical care quickly, or to an area where available medical facilities have limited resources or offer low standards of care, then you may be advised by a travel health professional to carry a course of standby emergency treatment (SBET) for malaria.

  • SBET is not a replacement for taking antimalarial tablets when travelling to a country with a risk of malaria.
  • If you think you may benefit from carrying SBET, you should see a travel health professional for a travel health risk assessment before travelling to a malaria-affected country:

For further information please see the Standby Emergency Treatment for Malaria page.

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