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Malaria is a disease spread to humans through the bites of mosquitoes. If you get malaria you can be very sick and may well require hospital treatment if it’s one of the more serious forms. So how do you get infected? Well, the Anopheles species of mosquito is the culprit. It's only the female mosquitoes that bite! When it takes a blood meal at night that's when you catch the infection. You should be aware of the symptoms and signs of malaria as it’s serious and potentially life-threatening but, if malaria treatment is taken early, it’s very effective. You're at risk of malaria in most of the tropical regions of the world but most cases occur in Sub Saharan Africa. In 2022 there were approximately 249 million malaria cases with an estimated 608,000 deaths. 90% of these cases and 92% of malaria deaths are in Africa.
Malaria, what is it?
Malaria tablets
You can use malaria pills for both treatment and as ‘anti-malaria medications’ before travelling to a high risk country to prevent the disease. Detailed information can be found in the Advisory Committee on Malaria Prevention Guidelines.
There are three main anti-malarial tablets licensed in the UK for prevention, which you can see below:
Malaria tablets range from is £0.80 per tablet or capsule to £5.20 per tablet or capsule. Before providing malaria treatment we'll complete a detailed risk assessment and provide highly specialised advice on what's right for you, there’s a small charge for our consultation of £30 per person.
Malaria tablets price
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You can prevent malaria in four, simple steps. The A, B, C, D of malaria prevention is easy to remember: 1. Awareness of the risk 2. Bite prevention (particularly at night time by use of repellent and nets) 3. Chemoprophylaxis (use of appropriate malaria tablets) 4. Diagnosis (prompt diagnosis and treatment) Remember, malaria tablets are not 100% effective, so you should also try to prevent insect bites with the following: - Wear long sleeved, neutral coloured clothing - Apply insect repellent containing 50% DEET, picardin, saltidin or Oil of Lemon Eucalyptus - Sleep under insecticide impregnated( permethrin) mosquito nets
Prevention
Malaria pills can be used for both treatment and as ‘anti-malaria medications’ before travelling to a country with a high risk of malaria.
Malaria treatment
The most common malaria symptoms are: - Fever - Chills - Headache - Overwhelming body and muscle ache If you experience any of these symptoms within 3 months of travelling to a country where malaria occurs, you should take the following actions: - Be aware that it could be malaria - Contact your doctor urgently - you should ask for an appointment the same day Tell your doctor to test you for malaria the same day - it’s a quick and simple blood test Make sure you get the malaria test result back within 24 hours as delaying the diagnosis means delayed treatment which can be serious - If you’re diagnosed quickly and given anti-malaria tablets promptly, you should make a full recovery - If, however, you delay seeking help, malaria treatment can be difficult and you may become seriously ill
Malaria symptoms
Malaria is caused by a parasite called Plasmodium. They’re microscopic organisms that multiply in humans and cause disease. This same malarial parasite is also able to multiply in the salivary gland of the Anopheles species of mosquito that’s present in much of the tropics. It’s this species that transmits the parasite to humans when taking a blood meal.
Malaria causes
Antimalarial side effects really depend on the malaria tablet you’re taking. Here are some possible (but not definite) side effects: Doxycycline: - Rash - Photosensitivity - Heartburn/gastritis Atovaquone/proguanil (Malarone, Maloff): - Headache - Abdominal pain - Diarrhoea Mefloquine (Lariam): - Headache - Abdominal pain - Diarrhoea - Abnormal dreams - Depression - Anxiety
Malaria tablets side effects
Frequently asked questions
The exact course depends on the type of malaria tablets you’re taking, please take a look at the malaria tablets table above.
Malaria transmission is constantly changing, so it’s worth having a detailed risk assessment with us before you travel. It’s not always what countries you’re travelling to, as your risk depends on your activities and your health as an individual. Sub-Saharan Africa is generally considered high risk, so you’re likely to require malaria pills for this region. You should also bear in mind that antimalarial medications are not 100% effective, and you should practice bite avoidance with insect repellent and insecticide treated bednets.
For more detailed information on malaria tablets and individual country destinations, please take a look at our vaccinations by country pages.
Our expert recommendation is that if you’re pregnant, you should not travel to a country with significant malaria transmission. This is because malaria is much more severe if you’re pregnant and it can also harm the baby.
If you don’t have a choice then there’s some evidence that mefloquine (Lariam) may be given in the 2nd and 3rd trimester. You should not take doxycycline as this can harm your baby and we don’t have enough information for the use of atovaquone/proguanil (Malarone, Maloff) in pregnancy.
For specialist, expert advice, please book an appointment . Please note that for complex medical problems, there is a consultation charge of £95 per person.
We usually define the incubation period as the time of infection (when the mosquito bites you) to the point of you manifesting the malaria symptoms. This is usually 7-30 days.
So, the important thing to remember is that if you develop a fever or become unwell within 1 month after returning from a country with malaria transmission, then see your doctor for an urgent malaria test.
Malaria is not contagious, as it’s transmitted through the bite of certain species of mosquitoes and not from person to person. Rarely, people have contracted malaria through unusual means, such as blood transfusions.
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Please note that proguanil on its own has now been discontinued in the UK
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You can only use chloroquine as an antimalarial medication in some parts of the world but not in Sub-Saharan Africa where there’s widespread malaria resistance to this drug. Instead, you can use any of the above.
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Mefloquine(Lariam) should not be used in the border areas of Myanmar, Laos and Thailand due to mefloquine resistance in this area. You can use either of the other two summarised in the table above.
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Authors:
Dr Ravi Gowda, Consultant in Infectious Diseases and Travel Medicine
MBBS, MRCP(UK), DTM&H, MRCGP, DCH, DRCOG, DFFP
Caitlin Lancaster, BSc
Resources: