Independent Nurse: Clinical - Travel medicine - Current advice on malaria prevention.

Malaria Awareness Week runs from 12-18 May. Sandra Grieve advises on bite prevention and chemoprophylaxis.

Malaria is a parasitic infection transmitted by the bite of a female Anopheles mosquito. Four types of malaria affect humans - Plasmodium falciparum (the most dangerous and life-threatening), P vivax, P ovale, and P malariae.

Malaria is one of the most important human diseases linked to foreign travel and the most important arthropod-borne infection reported in the UK.1 People visiting their country of origin are a recognised high-risk group, as they often believe they have retained immunity and do not need preventive measures.

HPA data show there were 1,758 imported cases of malaria in 2006 However, there was an increase in potentially fatal P falciparum infection, which was responsible for 79 per cent of cases and the eight deaths from malaria that occurred in 2006.1

Where a history of travel was available, more that half of imported UK cases were in minority ethnic groups. The majority of cases were associated with failure to take appropriate chemoprophylaxis.1

Risk assessment

Travellers to malaria endemic areas should be alerted to the possibility of acquiring infection. A thorough risk assessment is of paramount importance prior to advice on bite prevention and chemoprophylaxis. Malaria transmission can vary and travel to known areas of drug resistance will affect the advice given.

The TRAVAX and NaTHNaC websites provide useful risk assessment and risk management tools. They also include information on unusual outbreaks; practitioners should keep abreast of current information and direct travellers to the relevant websites.

The HPA Advisory Committee on Malaria Prevention in UK Travellers (ACMP) has produced new guidelines that combine previous advice on malaria prevention and …