Preventing malaria in travellers

#### Summary points Protecting travellers against malaria is increasingly important as the number travelling overseas continues to rise, with a disproportionate increase in visits to tropical areas where malaria transmission may occur. Each year about 1700 cases of malaria occur in the United Kingdom, 1300 in the United States, and 3000 in France.1 2 3 In the UK, about 75% of these cases are caused by Plasmodium falciparum , which produces the most severe form of malaria; five to 16 deaths occur annually and are nearly always in cases of falciparum malaria.1 Most infections occur in travellers resident in the UK, rather than in visitors to the UK. Malaria is a major risk for travellers if they do not take chemoprophylaxis or if they take incorrect prophylaxis.4 5 This review explores how to protect travellers from malaria. Most of the evidence base for malaria prophylaxis comes from small randomised controlled trials or observational studies. A useful approach is the “ABCD” of malaria prevention: Awareness of risk, Bite avoidance, Compliance with chemoprophylaxis, and the prompt Diagnosis of malaria (box 1) #### Box 1 Harm-benefit assessment based on the “ABCD” approach to malaria prevention* ##### Assessment and awareness of malaria risk ##### Bite avoidance ##### Chemoprophylaxis