Guidelines for malaria prevention in travellers from the United ...
Guidelines for malaria prevention in travellers from the United ...
Guidelines for malaria prevention in travellers from the United ...
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G UIDELINES FOR M ALARIA P REVENTION IN<br />
T RAVELLERS FROM THE U NITED K INGDOM<br />
48<br />
TABLE 10<br />
RISK<br />
Risk high<br />
Widespread<br />
chloroqu<strong>in</strong>e<br />
AND<br />
mefloqu<strong>in</strong>e<br />
resistance<br />
Risk high<br />
Chloroqu<strong>in</strong>e<br />
resistance<br />
common<br />
Risk variable<br />
Some<br />
chloroqu<strong>in</strong>e<br />
resistance<br />
Risk very low<br />
MALARIA CHEMOPROPHYLAXIS IN SOUTH EAST ASIA<br />
COUNTRY<br />
Cambodia (western prov<strong>in</strong>ces)<br />
Thailand (near ma<strong>in</strong>land borders with Cambodia, Laos<br />
and Myanmar; low risk and bite avoidance only Chiang<br />
Rai and Kwai bridge)<br />
Myanmar (eastern part of Shan State)<br />
Cambodia (except no risk <strong>in</strong> Phnom Penh)<br />
Ch<strong>in</strong>a (only <strong>in</strong> Yunnan and Ha<strong>in</strong>an; chloroqu<strong>in</strong>e <strong>in</strong> o<strong>the</strong>r<br />
remote areas of Ch<strong>in</strong>a)<br />
East Timor (= Timor-Leste)<br />
Papua (Irian Jaya) (part of Indonesia)<br />
Laos (except no risk <strong>in</strong> Vientiane)<br />
Lombok (part of Indonesia)<br />
Myanmar (<strong>for</strong>merly Burma [see above <strong>for</strong> Shan State])<br />
Malaysia East (Sabah only except Kota K<strong>in</strong>abalu where<br />
awareness and bite <strong>prevention</strong> advised)<br />
Vietnam (except areas listed below that are low risk)<br />
Indonesia (except Bali and cities where low risk; <strong>for</strong><br />
Papua (Irian Jaya) and Lombok mefloqu<strong>in</strong>e or doxycycl<strong>in</strong>e<br />
or atovaquone-proguanil recommended)<br />
Philipp<strong>in</strong>es (rural below 600m; no risk <strong>in</strong> cities, nor Cebu,<br />
Bohol and Catanduanes)<br />
Malaysia West (pen<strong>in</strong>sular) Inland <strong>for</strong>ested areas (not<br />
Cameron Highlands) and Malaysia East (<strong>in</strong>land <strong>for</strong>ested<br />
areas of Sarawak)<br />
Bali (part of Indonesia)<br />
Brunei<br />
Ch<strong>in</strong>a (ma<strong>in</strong> tourist areas <strong>in</strong>clud<strong>in</strong>g Yangtze cruises)<br />
Hong Kong<br />
Malaysia East (except Sabah (see above) and Sarawak<br />
(chloroqu<strong>in</strong>e plus proguanil)<br />
Malaysia West (low risk <strong>in</strong>clud<strong>in</strong>g Cameron Highlands<br />
except <strong>in</strong>land <strong>for</strong>ested areas where chloroqu<strong>in</strong>e<br />
plus proguanil)<br />
North Korea (a few sou<strong>the</strong>rn areas have limited risk)<br />
South Korea (limited risk <strong>in</strong> extreme Northwest)<br />
S<strong>in</strong>gapore<br />
Thailand (prophylaxis only advised <strong>for</strong> areas listed above)<br />
Vietnam (see above <strong>for</strong> high risk areas; low risk <strong>in</strong> cities,<br />
coast between Ho Chi M<strong>in</strong>h and Hanoi, and <strong>the</strong> Mekong<br />
River until close to <strong>the</strong> Cambodian border)<br />
ACMP<br />
RECOMMENDED<br />
REGIMEN<br />
Doxycycl<strong>in</strong>e<br />
OR<br />
Atovaquone/<br />
Proguanil<br />
Mefloqu<strong>in</strong>e<br />
OR<br />
Doxycycl<strong>in</strong>e<br />
OR<br />
Atovaquone/<br />
Proguanil<br />
Chloroqu<strong>in</strong>e plus<br />
proguanil<br />
Awareness*<br />
See tables 3-6 <strong>for</strong> details of regimens<br />
*Awareness of small risk of <strong>malaria</strong>; avoid mosquito bites and seek medical attention <strong>for</strong><br />
any suspicious symptoms (up to about a year later) but tablets not considered necessary.
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