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Giving advice on malaria prevention

By Professor David Bradley and Dr Barbara Bannister on behalf of the Advisory Committee on Malaria Prevention

Pharmacists are often asked to give advice on malaria prophylaxis to travellers. Therefore, it is vital that they are up to date with current recommendations. In the new guidelines, changes have been made to recommended regimens for malaria prophylaxis for the following three reasons:

  • Doxycycline is now licensed for prophylactic use.
  • The efficacy of chloroquine/proguanil is decreasing significantly in many areas of Africa frequently visited by UK travellers.
  • A new combination treatment, atovaquone/proguanil (Malarone), has been licensed for prophylactic use for up to one month.

The role of pharmacists is particularly important in relation to the areas for which chemoprophylaxis is not needed.

For most highly malarious places with chloroquine resistance, the choice is between prescription drugs, so the traveller will need to consult a doctor. However, for places with malaria risk that does not require chemoprophylaxis, the pharmacist could be the only health care professional consulted and the traveller’s life may depend on the advice given on prevention of mosquito bites and on the need for immediate medical advice in the event of a fever developing within three months (or more for vivax malaria) of leaving a malarious place, or while there.

The principles of prevention are the same throughout the world:

  • Awareness: know about the risk of malaria
  • Bites by mosquitoes: prevent or avoid
  • Compliance with appropriate chemoprophylaxis
  • Diagnose breakthrough malaria swiftly and obtain treatment promptly

Professor Bradley told The Journal that it was essential for pharmacists to understand all these aspects of malaria prevention, not just chemoprophylaxis, in order to give advice to travellers. It is important for pharmacists to refer to up-to-date reference sources when giving advice on malaria prophylaxis because recommended regimens change. In addition to the information in this article, other information sources are given in Panel 1.

Download the attached PDF to read the full article.

Citation: The Pharmaceutical Journal URI: 10977811

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