Personal protection for long term visitors to malarious areas

Malarone_tablets (source Wikimedia Commons)Whilst most of the measure for personal protection advised for short term visitors to malarious areas also apply for long-term visitors, the one exception is that long-term visitors will need to weigh up the pros and cons of taking malaria chemoprophylaxis for an extended period of time.

Different malaria chemoprophylaxis drugs are recommended for different maximum periods. Different countries also have different guidelines as to how long these different drugs should be taken for. Individual health status will also affect how long medical practitioners advise that a chemoprophylaxis course be continued for. It may be possible to change between chemoprophylaxis drugs to extend the period of time during which chemoprophylaxis can be taken. Advice on chemoprophylaxis must be based on the local recommendations for options but also, vitally, on each individual’s health status. For this reason the decision about which drug to take and how long to take it for must be made in consultation with a medical practitioner.

When staying longer term in a malarious area, local malaria epidemiology and risk should be taken into account when considering the benefit of using malaria chemoprophylaxis long-term. In some locations it may be advisable to take an initial course of malaria chemoprophylaxis in order to give time for the visitor to get used to the location and get used to being vigilant with bite protection measures; and then after this course rely on bite protection measures alone. This could be appropriate where transmission is lower and where the risks to the visitor in their primary location are fairly low. Even in countries with some areas of high transmission malaria can be very focal, and understanding the local risk is important in order to make informed decisions about the risks and benefits of long-term chemoprophylaxis use.

If long-term visitors stay in an area of lower transmission but move within the region or country to higher transmission areas for shorter visits, chemoprophylaxis could be considered for these shorter trips even if it has been discontinued in the primary location.

PDF For printing for visitors: WHO Information for travellers to malarious areas. PDF For printing for visitors: "Information sheet for visitors to a malarious region" Malaria FAQ PDF for printing for visitors: "Malaria FAQ"