Many travellers I see are travelling through areas where different malaria prevention tablets are recommended as they progress through their journey. How do we advise these travellers?
A. Travellers planning extensive journeys across continents will often travel into areas which have different malaria prevention recommendations. In these situations it is important that the traveller is protected in all areas of risk and the choice of medication needs to reflect the overall risk. It may be possible to move from one regimen to another, although for shorter trips this may not be practical. For example, a traveller visiting India for two weeks (where chloroquine plus proguanil may be recommended) and then going on to areas in Myanmar and Cambodia for six weeks (where mefloquine, doxycycline or atovaquone/proguanil may be recommended) would be advised to take either mefloquine, doxycycline or atovaquone/proguanil for the whole of the visit rather than change from chloroquine and proguanil to one of the other agents.
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