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Canada Communicable Disease Report

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Volume: 26S2 - March 2000

2000 Canadian recommendations for the prevention and treatment of malaria among international travellers
prepared by the
COMMITTEE TO ADVISE ON TROPICAL MEDICINE AND TRAVEL (CATMAT)

APPENDIX III Checklist for Travellers to Malarial Areas

The following is a checklist of key issues to be considered in advising travellers. The numbers in parentheses refer to those pages in the text where these issues are discussed in detail.

a) Risk of malaria (see section 2a, section 4, and Appendix I)

Travellers should be informed about their individual risk of malaria infection and the presence of drug-resistant P. falciparum malaria in their areas of destination. Pregnant women and adults taking young children should question the necessity of the trip.

b) Anti-mosquito measures (see section 2b)

Travellers should be instructed on how to protect themselves against mosquito bites.

c) Chemoprophylaxis (see section 3)

Travellers should be:

  1. advised to start chemoprophylaxis before travel, to use prophylaxis continuously while in malaria-endemic areas and for 4 weeks after leaving such areas (except for Malarone® and primaquine, which are taken for 1 week after leaving such areas).

  2. questioned about drug allergies and other contraindications for drug use.

  3. informed that antimalarial drugs can cause side effects; if these side effects are serious, medical help should be sought promptly and use of the drug discontinued. Mild nausea, occasional vomiting or loose stools should not prompt discontinuation of chemoprophylaxis, but medical advice should be sought if symptoms persist.

  4. warned that they may acquire malaria even if they use malaria chemoprophylaxis.

  5. warned that they may receive conflicting information regarding antimalarial drugs overseas, but that they should continue their prescribed medication unless they are experiencing moderate to severe adverse effects.

d) In case of illness (see section 7)

Travellers should be:

  1. informed that symptoms of malaria may be mild, and that they should suspect malaria if they experience a fever or flu-like illness (unexplained fever).

  2. informed that malaria may be fatal if treatment is delayed.

  3. informed that medical help should be sought promptly if malaria is suspected, and a blood film should be taken and examined for malaria parasites on one or more occasions (if possible, blood films should be brought home for review).

  4. reminded that self treatment (if prescribed) should be taken only if prompt medical care is not available within 24 hours and that medical advice should still be sought as soon as possible after self-treatment (see section 6).

  5. reminded to continue to take chemoprophylaxis in cases of suspected or proven malaria.

e) Special hosts (see section 4)

Pregnant women, young children and immunocompromised individuals require special attention because of the potential effects of malaria illness and inability to use some drugs. (Adapted from International Travel and Health, World Health Organization, Geneva, 1999).

 

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Important Notices