Individualized strategies needed for prevention of malaria in long-term travelers

drawbacks," the researchers write.

The authors add that vivax malaria (a form of malaria marked by convulsions that occur every 48 hours and caused by the parasite Plasmodium vivax) causes significant illness in travelers, but relapses of vivax malaria are not prevented with the current first-line chemoprophylaxis regimens.

"Long-term travelers to malaria-endemic areas face risk of death, morbidity, and reduced productivity because of malaria. General guidelines are desirable, but recommendations for malaria prevention in long-term travelers must be individualized and should be provided by travel medicine specialists. Personal protective measures are paramount. Identification of reliable medical facilities at destination is crucial for long-term travelers regardless of their malaria prevention strategies, and a number of resources are available to aid in this process. Data on safety of chemoprophylaxis drugs show reasonable clinical support for long-term use, particularly for mefloquine."

"All travelers should be advised to carry or arrange adequate supplies of antimalarial agents, because counterfeit drugs are rampant in developing countries. Long-term travelers should also consider evacuation insurance for medical emergencies," they write. "Presumptive antirelapse therapy should be considered for long-term travelers who have been intensively exposed to P vivax. Because inconsistent recommendations undermine the adherence to any preventive strategy, national and international experts should strive toward consensus on guidelines for malaria prevention in long-term travelers."


Contact: Kelly Kass
JAMA and Archives Journals

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