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Malaria is a serious infection, but it is largely preventable. In Westminster, we meet travellers who are unsure whether they need tablets, which ones are safe, and how to protect children or pregnant partners. There is no single best plan. The right advice depends on your destination, itinerary, medical history and the people travelling with you.

Start with the destination

Malaria risk varies widely between countries and even within regions. Sub-Saharan Africa carries the highest risk of severe malaria, but parts of South Asia, South-East Asia, Latin America, the Middle East and Oceania also require precautions. A city hotel with air conditioning is very different from a rural homestay, safari camp or construction site. Rainy seasons often increase risk. Visiting friends and relatives can be higher risk because stays are longer and further from tourist routes.

• Country, region and time of year
• Rural versus urban accommodation
• Screens, nets or air conditioning
• Length of stay and planned activities
• Pregnancy, age and long-term conditions

Antimalarial tablets: prevention, not treatment

Tablets reduce risk but do not remove it. They must be taken exactly as prescribed before, during and after travel. The best choice depends on your destination, medical history, pregnancy status and previous side effects. Common options include atovaquone-proguanil, taken daily and continued for seven days after leaving the risk area; doxycycline, taken daily and continued for four weeks, but not usually for children under 12 or in pregnancy; and mefloquine, taken weekly after a trial period, but avoided with a history of depression, seizures or certain heart problems. Other options exist for specific situations. Your GP will check interactions with medicines such as warfarin, some antibiotics, antidepressants and antiepileptics.

No tablet is 100% effective, so bite prevention remains essential. If you miss a dose, follow the leaflet or ask your prescriber rather than doubling up.

Bite prevention: practical steps

Malaria is spread by Anopheles mosquitoes, which mainly bite between dusk and dawn. Use a repellent containing 20–50% DEET or 20% picaridin on exposed skin, applied after sunscreen and reapplied as directed. Cover up with long sleeves, trousers and socks, especially in the evening. Light-coloured clothing is less attractive to mosquitoes. For high-risk trips, permethrin-treated clothing adds protection. Sleep under an insecticide-treated net if windows are unscreened, and use air conditioning or fans where possible. Plug-in mats and sprays can help but should not replace repellent or a net.

• Apply repellent to exposed skin, not under clothes
• Reapply after swimming or heavy sweating
• Use treated nets for cots and beds
• Keep doors and windows screened
• Avoid strong perfume after dark

Children, pregnancy and medical history

Malaria in pregnancy can be severe for mother and baby, and many tablets are unsuitable. If you are pregnant, breastfeeding or planning pregnancy, seek advice before booking. Children need weight-based doses, and some tablets are not licensed for young children. Repellents may be used from two months of age in many cases, but check first. Long-term conditions such as kidney or liver disease, epilepsy, mental health conditions and G6PD deficiency affect which tablet is safe. A private GP in Westminster can review your full history, arrange blood tests if needed, and prescribe appropriately for your family.

Before you travel — and after you return

Book a travel health appointment six to eight weeks before departure if possible, though last-minute advice is still valuable. Bring your itinerary and medication list. Your GP can review routine vaccines and prescribe antimalarials with clear start and stop dates. After returning, watch for fever, chills, headache, muscle aches, diarrhoea or flu-like symptoms for up to a year, especially in the first three months. Seek urgent medical advice and mention your travel history, even if you took tablets correctly. Early treatment is highly effective. Same-day private GP appointments in Westminster can help you act quickly and safely.