Travellers
Special groups
Pregnant women1
Pregnant women should be advised to avoid travelling to areas where malaria transmission occurs. They should be extra careful to protect themselves against mosquito bites, but should take care not to exceed the recommended dosage of insect repellents.
In areas where P.falciparum can be expected to be fully sensitive to chloroquine, prophylaxis with chloroquine alone may be used. However, chloroquine prophylaxis for P.falciparum is obsolete almost everywhere. In areas with a risk of malaria transmission and emerging chloroquine resistance, prophylaxis with chloroquine plus proguanil can be safely prescribed, even during the first three months of pregnancy. In areas where there is a high risk of falciparum malaria plus drug resistance, or moderate/low risk falciparum malaria but high drug resistance, mefloquine prophylaxis may be given during the second and third trimester.
Young children
Parents should be advised not to take babies or young children to areas with transmission of chloroquine-resistant P.falciparum. If travel cannot be avoided, children must be very carefully protected against mosquito bites and given appropriate chemoprophylactic drugs. Chloroquine and proguanil are safe for babies and young children but only suitable for areas with low levels of chloroquine resistance. Mefloquine may be given to infants of more than 5kg body weight.
Side-effects
All antimalarial drugs have specific contraindications and possible side-effects. Adverse reactions are common but most are minor and do not affect the activities of the traveller. Any traveller who develops serious side effects should stop taking the drug and seek immediate medical attention.
Because of the risk of adverse side effects, chemoprophylaxis should not be prescribed where there is no malaria risk. It is important to note that malaria is not present in all tropical countries. See latest WHO International Travel and Health publication. Click here for up-to-date countries list.
To help your patients understand malaria, and to provide them with a simple explanation of what they should do to stay healthy, you can download a copy of the Novartis patient leaflet
Alternatively, the following advice sheet can be printed out and given to patients.
