malaria prevention checklist

Last edited 12/2019 and last reviewed 10/2020

The best way to prevent malaria is to follow the ABCD of malaria prevention. Emphasise about:

• Awareness of risk - educate the traveler about the illness, where it is found etc
• Bite prevention -  see link
• Chemoprophylaxis
• should be taken one week (two and a half weeks for Mefloquine) before travel and for four weeks after return because of the malaria parasite's complex life cycle within the body. Most deaths occur in those who do not comply fully.
• prompt Diagnosis and treatment
• any fever or 'flu-like illness within a year of overseas travel (especially in the first three months) could be malaria. WARN PATIENT to obtain immediate medical attention. Diagnosis is by FBC with microscopy film (on up to three separate days). (1)

Emphasise that whilst no regimen is 100% effective, the combination of preventive measures advised will give significant protection against malaria (1)

Malaria bite protection

Bite prevention is the first line of protection against transmission of malaria.

To avoid mosquito bites:

• sleep in a screened room or in an air conditioned room, using a fly spray (usually a pyrethroid) to kill any mosquitoes that have entered during the day
• use intact mosquito nets at night specially if sleeping outdoors or in an unscreened accommodation -impregnation with permethrin 0.2g/sq m greatly enhances protection (re-impregnation of the nets should carried out every 6-12 months)
• use electric mat to vaporise synthetic pyrethroids overnight (electronic buzzers are useless)
• wear long sleeves and long trousers outdoors after sunset and avoid rural areas after dusk if possible. Clothing can be sprayed or impregnated with permethrin
• use repellants (eg DEET - diethyl toluamide) on exposed skin and garments (impregnation with 30ml DEET/250ml water renders clothing repellant) (2)
• avoid perfumes, cologne and aftershave lotion which can attract insects

Reference:

• (1) Public Health England. Guidelines for malaria prevention in travellers from the UK 2019
• (2) Health protection agency 2007. Guidelines for malaria prevention in travelers from the United Kingdom