Malaria - Preventing malaria

There is a significant risk of getting malaria if you travel to an affected area. It is very important you take precautions to prevent it.

Malaria can often be avoided using the ABCD approach to prevention which stands for:

• Awareness of risk – find out whether you are at risk of getting malaria.
• Bite prevention – avoid mosquito bites by using insect repellent, covering your arms and legs and using a mosquito net.
• Check whether you need to take malaria prevention tablets – if you do, make sure you take the right antimalarial tablets at the right dose, and finish the course.
• Diagnosis – seek immediate medical advice if you have malaria symptoms, including up to a year after you return from travelling.

These are outlined in more detail below.

Being aware of the risks

To check whether you need to take preventative malaria treatment for the countries you are visiting, see the Fit for Travel or the National Travel Health Network and Centre (NaTHNaC) websites.

It's also important to visit your GP or local travel clinic for malaria advice as soon as you know where you are going to be travelling.

Even if you grew up in a country where malaria is common, you still need to take precautions to protect yourself from infection if travelling to a risk area. No-one has complete immunity to malaria and any level of natural protection you may have had is quickly lost when you move out of a risk area.

Preventing bites

It is not possible to avoid mosquito bites completely but the less you are bitten, the less likely you are to get malaria.

To avoid being bitten:

• Stay somewhere that has effective air conditioning and screening on doors and windows. If this is not possible, make sure that doors and windows close properly.
• If you are not sleeping in an air-conditioned room, sleep under an intact mosquito net that has been treated with insecticide.
• Use insect repellent on your skin and in sleeping environments. Remember to re-apply it frequently. The most effective repellents contain DEET (diethyltoluamide) and are available in sprays, roll-ons, sticks and creams.
• Wear light loose-fitting trousers rather than shorts, and wear shirts with long sleeves. This is particularly important during early evening and at night, when mosquitoes prefer to feed.

There is no evidence to suggest that homeopathic remedies, electronic buzzers, vitamins B1 or B12, garlic, yeast extract spread (such as Marmite), tea tree oils or bath oils offer any protection against mosquito bites.

Antimalarial tablets

There is currently no vaccine available that offers protection against malaria, so it is very important to take antimalarial medication to reduce your chances of getting malaria.

However, antimalarials only reduce your risk of infection by about 90%, so taking steps to avoid bites is also important.

When taking antimalarial medication:

• Make sure you get the right antimalarial tablets before you go (check with your GP or pharmacist if you are unsure). 
• Follow the instructions included with your tablets carefully.
• Continue to take your tablets for up to four weeks (depending on the type you are taking) after returning from your trip to cover the incubation period of the disease.

Check with your GP to make sure you are prescribed a medication you can tolerate. You may be more at risk from side effects if you:

• have HIV or AIDS
• have epilepsy or any type of seizure condition
• are depressed or have another mental health condition
• have heart, liver or kidney problems
• take medicine, such as warfarin, to prevent blood clots
• use combined hormonal contraception, such as the contraceptive pill or contraceptive patches

If you have taken antimalarial medication in the past, don't assume that it is suitable for future trips. The antimalarial you need to take will depend on which strain of malaria is carried by the mosquitoes and whether they are resistant to certain types of antimalarial medication.

In the UK, chloroquine and proguanil can be bought over the counter from local pharmacies, although you should seek medical advice before buying it because it is rarely recommended nowadays. For all other antimalarial tablets, you will need a prescription from your GP.

Read more about antimalarial medication, including the main types and when to take them.

Get immediate medical advice

If you become ill while travelling in an area where malaria is found or after returning from travelling, you must seek medical help straight away – even if you have been taking antimalarial tablets.

Malaria can get worse very quickly, so it's important that it is diagnosed and treated as soon as possible.

If you develop symptoms of malaria while still taking antimalarial tablets (either while you are travelling or in the days and weeks after you return), remember to tell the doctor which type you have been taking. The same type of antimalarial should not be used to treat you as well.

If you develop symptoms after returning home, visit your GP or a hospital doctor and tell them which countries you have travelled to in the last 12 months, including any brief stopovers.