Effectiveness of malaria chemoprophylaxis against Plasmodium falciparum infection in UK travellers: retrospective observational data.

What is already known on this topic. Malaria is a potentially life-threatening disease, and cases of imported Plasmodium falciparum malaria have increased among UK travellers over the past 20 years, although declining steadily in recent years. The HPA Advisory Committee on Malaria Prevention (ACMP) UK Traveller guidelines recommend doxycycline, mefloquine, or combination atovaquone plus proguanil for prophylaxis in travellers to P. falciparum endemic regions, and with the exception of Lambeth Primary Care Trust, malaria chemoprophylaxis is not reimbursed by the NHS. There are limited data on the comparative effectiveness of the recommended malaria chemoprophylaxis drugs for P. falciparum. What this study adds. The effectiveness of combination atovaquone plus proguanil may provide greater protection against imported P. falciparum malaria in UK travellers as compared with doxycycline and mefloquine. More research is needed on the effectiveness of different chemoprophylactic regimens. Further work is required to ascertain whether ease of use and compliance may be important factors in the outcomes associated with malaria chemoprophylaxis.