Tuesday, 29 July 2014

Malaria Guidelines for 2014

The updated Guidelines for malaria prevention in travellers from the UK for 2014 were published on the Health Protection England website this afternoon.  For a downloadable copy of the document click HERE.
NaTHNaC have written a useful resume of the key changes in this document from the 2013 edition - for full details see here.

One of the biggest changes is the advice for travellers going to India and the map is quite different to that posted in the 2007 guidelines - see the latest version below.  Where there is orange/peach coloured shading the travel advice after assessment is strict bite prevention measures plus taking either atovaquone plus proguanil or doxycycline or mefloquine (which ever is suitable and preferred by the traveller). Chemoprophylaxis is now no longer routinely recommended for the other areas.  However for these destinations the committee who write the guidelines (called ACMP) have stated

"A recommendation for bite prevention plus awareness of risk does not mean there is NO risk of malaria in the place in question, but indicates that ACMP considers the level of risk to be below the threshold for recommending chemoprophylaxis. As bite avoidance is now the main preventive measure for most of India, rigorous adherence to the recommendations in Chapter 3 is strongly advised. The final decision whether or not to advise chemoprophylaxis rests with the travel health advisor and the traveller after individual risk assessment has been performed.  Whilst the local malaria situation is the same for all travellers to a given location, long-term VFR visitors run a higher risk. Furthermore, once infected the risk of developing severe or complicated malaria is higher in certain groups eg the elderly and especially pregnant women.  Therefore, whether or not chemoprophylaxis is advised, special attention must be given to bite prevention and febrile illness must be taken seriously and investigated promptly."

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