Malaria – when do I need to take malaria tablets?
In this article we will explore what causes malaria and discuss the importance of malaria prevention through chemoprophylaxis (preventative medications).
Imported malaria in the UK
Malaria is an infectious disease caused by a group of parasites of the genus Plasmodium. Humans are infected when bitten by an infected mosquito. Severe disease can be life threatening, with complications causing low blood levels, confusion, kidney failure and death.
Malaria is not endemic to the UK- this means that all recorded cases are people who have entered the UK from other countries. The most common parasite imported to the UK is Plasmodium falciparum accounting for 85.8% in 2021.
Other parasites include Plasmodium vivax, Plasmodium ovale, Plasmodium knowlesi and Plasmodium malariae and these differ by global distribution and contact with certain species of animal. In 2021, of the 1,021 cases of imported malaria, there were 3 deaths secondary to severe disease associated with Plasmodium falciparum.
The most common reason for travel in those identified as having malaria in 2021 was visiting friends and relatives (70%). Those visiting West African countries such as Nigeria, Ghana and Sierra Leone were particularly at risk.
Amongst UK imported malaria cases, the vast majority did not take or adhere to malaria chemoprophylaxis. Adherence to malaria chemoprophylaxis is associated with a 90% reduction in malaria transmission. Surveillance data suggests that groups at particular risk of not using chemoprophylaxis are those visiting friend or relatives in their country of origin, and in particular people of black African heritage and/or born in Africa. Reasons for this are uncertain and further exploration into this trend is important to facilitate change.
Figure 1. Countries of travel for cases of malaria that travelled abroad from the UK by count of cases, 2021 (from 2021 annual malaria report, UK Gov, accessed on 16/7/23
How to access malaria chemoprophylaxis?
Malaria chemoprophylaxis is not available on the NHS.
The recommended malaria prevention tablets can be purchased over the counter e.g. Chloroquine, Proguanil and Atovaquone plus proguanil (Malarone), or are available on private prescription e.g. mefloquine and doxycycline. The medication differ in terms of course, suitability based on medical conditions and side effect profile. For those with underlying health conditions, it is advisable to discuss options with your GP or a travel clinic physician prior to purchase.
The key message
All people travelling abroad should check for malaria risk prior to departure. Individuals should check the ‘Fit for Travel website’ for up to date advice as occasionally lower-risk countries may be experiencing a malaria outbreak. Advice should be sought from a travel medic or GP prior to purchase to help select the best medication for each individual.
Last edited 24.7.23
