What advice should I give to travellers who discontinue their malaria prevention tablets on or after their return to the UK due to adverse events?
A. Atovaquone/proguanil If atovaquone/proguanil (Malarone ®) is discontinued before completing 7 days dosage post-return, no additional malaria prevention drug need be recommended. The traveller must be warned of the increased risk of malaria compared with those who take the full dosage regimen. Increased vigilance is required and if the traveller becomes unwell in the first year after return, a blood test for malaria should be obtained without delay. Chloroquine, doxycycline, proguanil, or mefloquine (Suppressive malaria prevention) If suppressive malaria prevention is discontinued before completing 4 weeks dosage post-return, no additional malaria prevention drug need be recommended. The traveller must be warned of the increased risk of malaria compared with those who take the full dosage regimen. Increased vigilance is required and if the traveller becomes unwell in the first year after return, a blood test for malaria should be obtained without delay.
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