Guidelines for malaria prevention in travellers from the United ...

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G UIDELINES FOR M ALARIA P REVENTION IN T RAVELLERS FROM THE U NITED K INGDOM 48 TABLE 10 RISK Risk high Widespread chloroquine AND mefloquine resistance Risk high Chloroquine resistance common Risk variable Some chloroquine resistance Risk very low MALARIA CHEMOPROPHYLAXIS IN SOUTH EAST ASIA COUNTRY Cambodia (western provinces) Thailand (near mainland borders with Cambodia, Laos and Myanmar; low risk and bite avoidance only Chiang Rai and Kwai bridge) Myanmar (eastern part of Shan State) Cambodia (except no risk in Phnom Penh) China (only in Yunnan and Hainan; chloroquine in other remote areas of China) East Timor (= Timor-Leste) Papua (Irian Jaya) (part of Indonesia) Laos (except no risk in Vientiane) Lombok (part of Indonesia) Myanmar (formerly Burma [see above for Shan State]) Malaysia East (Sabah only except Kota Kinabalu where awareness and bite prevention advised) Vietnam (except areas listed below that are low risk) Indonesia (except Bali and cities where low risk; for Papua (Irian Jaya) and Lombok mefloquine or doxycycline or atovaquone-proguanil recommended) Philippines (rural below 600m; no risk in cities, nor Cebu, Bohol and Catanduanes) Malaysia West (peninsular) Inland forested areas (not Cameron Highlands) and Malaysia East (inland forested areas of Sarawak) Bali (part of Indonesia) Brunei China (main tourist areas including Yangtze cruises) Hong Kong Malaysia East (except Sabah (see above) and Sarawak (chloroquine plus proguanil) Malaysia West (low risk including Cameron Highlands except inland forested areas where chloroquine plus proguanil) North Korea (a few southern areas have limited risk) South Korea (limited risk in extreme Northwest) Singapore Thailand (prophylaxis only advised for areas listed above) Vietnam (see above for high risk areas; low risk in cities, coast between Ho Chi Minh and Hanoi, and the Mekong River until close to the Cambodian border) ACMP RECOMMENDED REGIMEN Doxycycline OR Atovaquone/ Proguanil Mefloquine OR Doxycycline OR Atovaquone/ Proguanil Chloroquine plus proguanil Awareness* See tables 3-6 for details of regimens *Awareness of small risk of malaria; avoid mosquito bites and seek medical attention for any suspicious symptoms (up to about a year later) but tablets not considered necessary.
MALARIA CHEMOPROPHYLAXIS IN OCEANIA TABLE 11 ALTERNATIVE REGIMEN IF RECOMMENDED REGIMEN UNSUITABLE ACMP RECOMMENDED REGIMEN COUNTRY RISK Chloroquine plus proguanil (Limited protection) Doxycycline OR Mefloquine OR Atovaquone/ Proguanil Papua New Guinea below 1800m Solomon Islands Vanuatu Risk high Chloroquine resistance high G UIDELINES FOR M ALARIA P REVENTION IN T RAVELLERS FROM THE U NITED K INGDOM See tables 3-6 for details of regimens 49
Page 1 and 2: Guidelines for Malaria Prevention i
Page 3 and 4: ABBREVIATIONS G UIDELINES FOR M ALA
Page 5 and 6: G UIDELINES FOR M ALARIA P REVENTIO
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Page 21 and 22: 2. Awareness of Risk 2.1 What is ma
Page 23 and 24: 2.3 The malarial illness Malaria ca
Page 25: ut the risk of contracting malaria
Page 28 and 29: G UIDANCE UIDELINESFROM FOR THE M A
Page 63 and 64: 5. Diagnosis Suspected malaria is a
Page 69 and 70: individuals' medical history should
Page 71 and 72: 6.9 Liver disease Most antimalarial
Page 73 and 74: 7 - Special Categories 7.1 Children
Page 75 and 76: 7. Special Categories 7.1 Children
Page 77 and 78: As examples, cruises in the Caribbe
Page 79 and 80: 7.10 Students and children at board
Page 81 and 82: FIGURE 8 Efficacy of regimens It is
Page 83 and 84: TABLE 16 TABLE 17 G UIDELINES FOR M
Page 85 and 86: 8.1 What malaria prevention should
Page 87 and 88: 8. Frequently Asked Questions G UID
Page 97 and 98: 9. Information Resources 9.1 Expert
Page 99 and 100: 9.4 References 1 General Medical Co
Page 101 and 102:
29 Hill DR. Travel Associated Disea
Page 103 and 104:
56 Steketee RW, Wirima JJ, Slutsker
Page 105 and 106:
Membership of the HPA Advisory Comm
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