TY - JOUR T1 - Malaria in the UK: new prevention guidelines for UK travellers JF - British Journal of General Practice JO - Br J Gen Pract SP - 4 LP - 6 VL - 57 IS - 534 AU - Barbara Bannister Y1 - 2007/01/01 UR - http://bjgp.org/content/57/534/4.abstract N2 - Malaria is a major disease worldwide, with around 300 million cases and 1 million deaths annually.1 The transmission of malaria is diminishing in some countries, such as the Indian subcontinent, probably due to a combination of better living conditions, education, urbanisation, and better water management which reduce the numbers of mosquito vectors. In Africa, transmission remains at a high level. The effectiveness of drugs locally-used for treatment, such as pyrimethamine plus sulphadoxine (Fansidar® [Roche]) is now so significantly reduced that the UK guidelines no longer recommend this drug for emergency standby treatment.2 Artemisinin drugs are widely used for treatment in Africa but have not been investigated for use as prophylactic drugs. Only one artemisinin combination drug (co-artemether; Riamet® [Novartis]) is licensed in European countries, but is not for prophylactic use. A small proportion of Plasmodium vivax parasites in Indonesia, and occasionally in East Africa, have shown evidence of resistance to chloroquine.3 This is rare, and does not alter the recommendations for prophylaxis in the guidelines.Malaria is the most common tropical infection imported into the UK, with around 1500 to 2000 notified cases each year.2 However, informal surveys conducted by the Malaria Reference Laboratory and by Infectious and Tropical Diseases Centres suggest that notified cases represent only about half of all diagnosed cases. Between nine and 15 deaths from malaria occur each year, but the numbers recovering from severe or life-threatening malaria are unknown.While a minority of cases occur in visitors from overseas, almost 60% of reported cases are travellers who departed from and returned to the UK. Nearly all of these cases could be prevented by a combination of mosquito avoidance measures and chemoprophylaxis. Thus, approximately 1800–2400 cases of preventable malarial disease occur in UK residents each year. This is an important burden of … ER -