Chemoprophylaxis of Malaria for Travelers

Abstract

Physicians advising travelers going to parts of the world where malaria transmission occurs should recommend antimalarial prophylaxis. Chloroquine is the most reliable prophylactic agent affording prophylactic suppressive cure of all sensitive strains of falciparum malaria and suppression with occasional cure of other human malarias. A 14-day course of primaquine after the last exposure affords prophylactic radical cure of malarias with secondary exoerythrocytic cycles. A weekly combination of chloroquine and primaquine is equally effective if continued for 2 months after exposure, but is unnecessary for travelers visiting areas with chloroquine-sensitive malaria. Currently, the best prophylaxis for chloroquine-resistant falciparum malaria is weekly chloroquine and primaquine and daily dapsone. Travelers should be informed about simple precautions against mosquito bites and should advise their physician of the possibility of malaria if they become ill after they return.