All travellers should be told that protection from biting mosquitos is their first line of defence against malaria. Practical measures for protection are described in Box 5.2 Take chemoprophylaxis where appropriate . Prophylactic antimalarial regimens should be started one week before travel or, in the case of proguanil or doxycycline, the day before travel. Drugs should then be taken with unfailing regularity for the duration stay in the area of malaria risk, and continued for 4 weeks after leaving the area. Drugs should be taken with food and swallowed with plenty of water.
Adverse reactions attributed to malaria chemoprophylaxis are common.
Most of these are minor and do not affect the activities of the traveller. However, the risk associated with the drug should be weighed against the risk of malaria, especially falciparum malaria. Chemoprophylaxis should not be prescribed in the absence of malaria risk. Severe adverse reactions during prophylaxis with amodiaquine or sulfadoxine-pyrimethamine have led to their deletion from the list of drugs recommended by WHO for prophylaxis. Seek early diagnosis and treatment .