Box 3.

Malaria chemoprophylaxis by continent (depending on season and area visited)

The Advisory Committee on Malaria Prevention for UK Travellers recommends:

• North Africa and Middle East—chloroquine alone or chloroquine plus proguanil

• Sub-Saharan Africa—mefloquine, doxycycline, or atovaquone plus proguanil

• South Asia—chloroquine plus proguanil

• South East Asia—mefloquine, doxycycline, or atovaquone plus proguanil (Indonesia and forests of Malaysia and Sarawak—chloroquine plus proguanil)

• Oceania—mefloquine, doxycycline, or atovaquone plus proguanil

• Latin America—mefloquine, doxycycline, or atovaquone plus proguanil

• Caribbean—chloroquine plus proguanil or chloroquine alone

Malaria chemoprophylaxis regimens

• Chloroquine—two tablets taken weekly starting a week before travel to endemic area and continuing for four weeks after leaving malarious area

• Proguanil—one tablet daily starting a week before travel to endemic area and continuing for four weeks after leaving malarious area

• Doxycycline—one tablet daily starting one day before travel to endemic area and continuing for four weeks after leaving malarious area

• Atovaquone plus proguanil (Malarone)—one tablet daily starting one day before travel to endemic area and continuing for seven days after leaving malarious area

• Mefloquine—one tablet weekly starting trial dose three weeks before departure if appropriate and continuing for four weeks after leaving malarious area