Development of recommendations for the protection of short-stay travellers to malaria endemic areas: Memorandum from two WHO Meetings.

In the past, since malaria chemoprophylaxis was assumed to be of benefit and with no serious complications, it was recommended to all travellers who were at risk of acquiring the disease. The current epidemiological situation of malaria is marked by the increasing spread of Plasmodium falciparum resistance to chloroquine and by problems due to the toxicity of other drugs. Recommendations for malaria prophylaxis should therefore be based on an epidemiological approach which takes into account the risk of acquiring the infection, the toxicity and effectiveness of the available antimalarial drugs, the traveller's perception of these risks, and the human factors that influence the use of all possible protective measures against malaria.This Memorandum describes the epidemiological approach and the data bases required for the development of recommendations on prophylaxis for short-stay visitors in malaria endemic areas, and gives guidelines on the protective measures and drugs that may be used in defined situations.