The UKHSA Guidelines for Malaria Prevention 2022 have been published today and although it's now 2023, this publication reflects the changes that happened for 2022 with the anticipated update for 2023 coming out later this year.
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I have listed 4 points of particular interest and/or where some of the information has been updated
1. A new aesthetic appearance of the document to the UKHSA 'blue' from the previous PHE 'maroon'. Whilst the index and tables, maps etc. have been hyperlinked again to the relevant pages for each topic from the contents page 2 onwards, another really helpful feature is that all the references in Vancouver style have now also been hyperlinked throughout the body of the text as well, to the reference list on page 160 to 169. Some of these references have then been hyperlinked to the actual documents, where some are available.
2. The chapter on 'Bite prevention' starting on page 20, has been updated and there are a few items which have been enhanced and/or expanded. One which is helpful is more detail about use of repellents in infants. The publication states: In some circumstances, ACMP advice may differ from that in repellent manufacturers’ product information. When this occurs, the recommendations in these guidelines (which are based on current expert advice from the ACMP) should be followed.
So for example, in the section on DEET and infants is says, DEET is not recommended for infants below the age of 2 months. If a particular DEET manufacturer’s product information recommends a higher age cut off for use in children, the ACMP guidance should be followed.
On page 23 there is expanded information about plant-based repellents acknowledging they have become more popular in recent years. The guidelines comment that for those travellers preferring plant-based repellents, Eucalyptus citriodora oil, hydrated, cyclized is the only active ingredient recommended by ACMP. So, Eucalyptus citriodora oil, hydrated, cyclized is also an effective repellent. The guidance goes on to state that 15% DEET slightly outperformed 15% Eucalyptus citriodora oil, hydrated, cyclized as a repellent against Anopheles stephensi under laboratory conditions, but Eucalyptus citriodora oil, hydrated, cyclized remains a very useful repellent. If Eucalyptus citriodora oil, hydrated, cyclized is chosen by the traveller, more frequent application would be required than if DEET were used. See page 23 for further details.
3. The General Issues notes on page 12 should be read as they are helpful and this year they also acknowledge that for doctors and nurses providing travel services in England who are regulated by the Care Quality Commission (CQC), the CQC website confirms that the provision of travel health services includes pre-travel risk assessments and travel health advice including malaria prevention.
4. Useful statements (that were previously FAQs) are found on page 77 - 86, but are not detailed in the contents list. These cover the following topics
- Malaria prevention advice for travellers going on cruises
- Once you get malaria, it keeps coming back – true or false
- Alternative antimalarial drugs which can be used for areas where chloroquine and proguanil are advised if they are unsuitable for a particular traveller
- Which antimalarial to give to a traveller with a history of psoriasis
- Which antimalarial to give a traveller who is taking anticoagulants
- How long a traveller can take different antimalarial drugs
- Antimalarial drugs which are suitable for women during pregnancy
- Antimalarial drugs which can be taken by women breastfeeding
- The easiest way to calculate the correct dose of chloroquine for babies and young children
- Advice for travellers travelling through areas where different antimalarials are recommended
- Antimalarial drugs for a traveller who has epilepsy
- Advice for a traveller with glucose 6- phosphate dehydrogenase deficiency
- Advice for people working on oil rigs
- Advice for the traveller on a stopover
- Doxycycline’s effect on oral contraception
- Advice for travellers who discontinue chemoprophylaxis on or after return to the UK due to drug side-effects
