Almost all malaria deaths in travellers are secondary to infection with P. falciparum and the great majority of these infections are acquired in sub-Saharan Africa. It should be emphasized that the majority of infections are preventable. While it is the most accurate information at the time of publication, many factors may have profound effects on local malaria transmission. Transmission occurs between dusk and dawn, corresponding to the biting habits of the female Anopheles mosquito. The risk of transmission is increased in rural areas and varies seasonally in many locations, being highest at the end of the rainy season.
Risk is dependent upon the duration of an individual s exposure.
ALL travellers to malaria-endemic zones are advised to use personal insect protective measures to reduce the risk of bites from Anopheles mosquitos. In addition, the use of insect repellent on exposed skin, particularly between dusk and dawn, is strongly recom-mended. Regardless of the concentration, repellency rates are equivalent but higher concentrations protect for longer periods of time. Impregnated bed nets are available in Canada and should be used in conjunction with the above measures. Several factors need to be assessed when selecting an appropriate chemosuppressive regimen before travel.