Mefloquine may therefore be given during the second and the third trimesters. Data concerning use during the first trimester are limited. Other drugs are either dangerous to the fetus or insufficiently investigated to be prescribed for prophylaxis in pregnancy. In non-pregnant women of childbearing potential, mefloquine or doxycycline can be given, but pregnancy should be avoided for three months after completing prophylaxis in the case of mefloquine, and for one week in the case of doxycycline. However, in the case of unplanned pregnancy, malaria chemoprophylaxis is not considered an indication for pregnancy termination.
Children are at special risk since they can rapidly become seriously ill with malaria.
Fever in a child returning from a malarious area should be considered to be due to malaria until proved otherwise. Every attempt must be made to seek prompt medical help, even if stand-by treatment is given. It is sometimes difficult to give an adequate prophylactic dose of a drug because of the small amount required and lack of paediatric formulations. Long-term travellers . The recommendations given throughout this section are applicable only to non-immune travellers visiting malarious areas for up to one month, which includes most travellers.