Prevention

Avoid exposure

• Exercise particular caution during peak biting periods

• Mosquito nets

• Protective clothing (covering most of the skin, light colors)

• Mosquito repellent, such as DEET (N,N-diethyl-meta-toluamide)

Mosquito control

• Reduce breeding sites (e.g., eliminate pools of water, optimize plant watering)

• Insecticide spraying

Should be initiated before traveling to regions with a high risk of malaria, e.g., tropical Africa, Asia, and Central/South America

Drug of choice is based on the region traveled and Plasmodium species

• Areas with P. falciparum

  • If chloroquine-resistant P. falciparum (most malaria endemic regions): atovaquone-proguanil, doxycycline, mefloquine

  • If chloroquine-sensitive P. falciparum: chloroquine

• Areas without P. falciparum (some areas of Central/South America, Mexico, China, South Korea): primaquine

Agents that are safe during pregnancy: chloroquine, mefloquine

Indication

• Traveling to endemic regions with a medium to high risk of malaria

• Depending on the risk, either prophylactic or standby emergency treatment may be recommended (when in doubt: prophylactic medication).

Drugs

• Atovaquone-proguanil

• Artemether-lumefantrine

• Chloroquine with limitations: there are now many chloroquine-resistant Plasmodium strains with membrane pumps that lower intracellular chloroquine concentrations