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Malaria prevention

Approved by our Clinical team | Mar 19, 2020

How to protect yourself from malaria

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Malaria is a tropical disease spread by mosquitoes that causes a fever, chills, sweating, nausea, vomiting, and aches and pains. In serious cases it can lead to life-threatening complications, which means malaria prevention techniques must be practised in high-risk areas.

The steps that travellers take to avoid the disease are sometimes referred to as malaria prophylaxis. Prophylaxis is the technical term for preventative action or treatment taken to avoid illness. Malaria prophylaxis involves a mixture of mosquito bite prevention and, where necessary, antimalarial tablets.

If you are travelling to a malaria zone within the next few months, it’s a good idea to familiarise yourself with malaria prophylaxis techniques. It’s recommended that, before leaving the country, you get malaria advice from your GP or a travel nurse, or through a service such as LloydsPharmacy Online Doctor. You can also get some simple guidance by reading the following article.

What does malaria prophylaxis involve?

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Protecting yourself from malaria while travelling should begin with research. Upon arrival in a country affected by malaria you should begin to practise mosquito bite avoidance. In areas where the risk is particularly high, you should take antimalarials as they have been prescribed.

Much of the official advice relating to malaria prophylaxis makes reference to the ABCD method:

Awareness of risk (checking whether your destinations are affected by malaria and how you should protect yourself)
Bite avoidance (e.g. using mosquito repellent and staying in adequately protected accommodation)
Chemoprophylaxis (where necessary, using antimalarial tablets)
Diagnosis and treatment (getting prompt medical advice if you begin experiencing symptoms)

When it comes to “awareness of risk”, it’s strongly recommended that you speak to a medical professional before leaving the country. They will be able to advise you on whether you need antimalarial tablets and, if so, how to take them correctly. They will also be able to advise you on other travel needs such as vaccinations.

If you want to research your malaria risk yourself, you can use resources such as Travel Health Pro. Bear in mind that risk zones change fairly often, so you will need to refer to up to date information.

Bite avoidance

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A key element of malaria prophylaxis is mosquito bite avoidance. When visiting a country affected by malaria, bite prevention techniques should be your top priority. This is for two reasons:

Antimalarial tablets cannot provide 100% protection
Mosquitoes can carry other dangerous diseases such as dengue fever

You can avoid getting bitten by following these tips:

Wear long, loose trousers and long-sleeved tops to keep your skin covered, particularly between dusk and dawn when the mosquitoes that carry malaria are most active
Apply insect repellent to areas of exposed skin; repellents containing 20-50% DEET are the most effective, but you can also use repellents containing icaridin or lemon eucalyptus
Book accommodation with insect screens on the windows and doors, and air conditioning
When sleeping in more basic accommodation, sleep under a mosquito net sprayed with insecticide/mosquito repellent
Use plug-in insecticides

Chemoprophylaxis

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Chemoprophylaxis is a term that describes medical treatments taken to prevent illness. Malaria chemoprophylaxis refers to antimalarial tablets, which should be taken in particularly high-risk areas.

Usually you have to obtain antimalarials with a prescription. The three most common malaria tablets prescribed in the UK are atovaquone and proguanil (malarone), doxyxcyline, and mefloquine (lariam).

You can purchase atovaquone and proguanil (branded as maloff) over the counter without a prescription, however it is recommended that you speak to a medical professional before you do this. You can also purchase an antimalarial called chloroquine/proguanil over the counter, however this type is not effective in all areas affected by malaria. Before obtaining chloroquine/proguanil you should speak to a doctor or nurse to ensure that you will be adequately protected.

If you require antimalarials during your trip you will have to start taking them before you enter the malaria zone, and continue taking them after you have left. Different antimalarials have to be taken in different ways and for different lengths of time; get advice from your doctor or pharmacist, and always take your tablets exactly as directed.

Diagnosis and treatment

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If you follow the malaria prophylaxis guidance described above you should be properly protected, however it is still possible to become infected. Usually, malaria parasites incubate in the liver for at least one week before they begin causing symptoms. For this reason, if you begin experiencing symptoms within just a few days of entering a malaria zone (from a non- malaria zone) it’s unlikely that you have malaria.

If you begin experiencing symptoms after you have been in a malaria zone for at least one week, you should visit a doctor as soon as possible; certain types of malaria can cause serious complications and require swift diagnosis and treatment.

The symptoms of malaria include:

Fever
Chills and shivering
Sweating
Headache
Nausea and vomiting
Aches and pains
Diarrhoea

Sometimes the symptoms of malaria occur in cycles. You may experience bouts of fever, chills, and sweating every two or three days. Not all people infected with malaria experience these cyclical bouts of symptoms. For that reason, it’s advised that you seek medical advice regarding malaria as soon as you experience any of the symptoms described above (provided you have been in a malaria zone for at least one week).

Find out more by visiting the malaria clinic at LloydsPharmacy Online Doctor.

How long can you take malaria prophylaxis?

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Malaria prophylaxis includes antimalarials and bite avoidance, the length of time you need to take your tablets will depend on the type of antimalarial you have. However, prophylaxis should be started before you travel, this could be 1-2 days or a week before, the exact time will be stated in the patient information leaflet. For the majority of antimalarials the dosage is one tablet a day while you are in a malaria risk zone, and then they can be taken up to 4 weeks after you return home.

Alongside antimalaria tablets you will need to practise bite avoidance by using mosquito nets, DEET sprays, covering legs and arms with clothing. Malaria prophylaxis in pregnancy can also include DEET sprays however ingesting these should be avoided, if you are breastfeeding is it advised that you wash your hands and breasts before feeding your baby.