Malaria in travellers: epidemiology and prevention.

Malaria continues to be a serious health risk for travellers. The malaria parasites which infect humans can only be naturally transmitted by female mosquitoes of the genus Anopheles. Travellers to malaria endemic areas require detailed advice on appropriate chemoprophylaxis against malaria and personal protection against mosquito bites. The decision on an appropriate chemoprophylaxis or standby therapy regimen should reflect the malaria risk, pattern of drug resistance, and the toxicity of available drugs. Currently travellers encounter a number of problems in protecting themselves against malaria. Advice is often both inadequate and inaccurate; and all the recommended drug regimens are associated with minor, and occasionally major adverse reactions. Because of poor compliance to drug prophylaxis and to reduce the impact of drug resistance, protection against mosquitoes has a critical role in protecting travellers from malaria. Compliance to methods of personal protection not only reduces the malaria risk but also limits the nuisance and loss of sleep from biting insects.