Malaria in the UK: new prevention guidelines for UK travellers

摘要

Malaria is a major disease worldwide, with around 300 million cases and 1 million deaths annually.1 The transmission of malaria is diminishing in some countries, such as the Indian subcontinent, probably due to a combination of better living conditions, education, urbanisation, and better water management which reduce the numbers of mosquito vectors. In Africa, transmission remains at a high level. The effectiveness of drugs locally-used for treatment, such as pyrimethamine plus sulphadoxine (Fansidar#x000ae; Roche) is now so significantly reduced that the UK guidelines no longer recommend this drug for emergency standby treatment.2 Artemisinin drugs are widely used for treatment in Africa but have not been investigated for use as prophylactic drugs. Only one artemisinin combination drug (co-artemether; Riamet#x000ae; Novartis) is licensed in European countries, but is not for prophylactic use. A small proportion of Plasmodium vivax parasites in Indonesia, and occasionally in East Africa, have shown evidence of resistance to chloroquine.3 This is rare, and does not alter the recommendations for prophylaxis in the guidelines.