A brief history
Malaria once affected areas well beyond today's tropical risk regions. Scientists identified malaria parasites in human blood in 1880; research in the late 1890s established the mosquito's role in transmission. These discoveries helped shift prevention towards mosquito control and medicines that act on the parasite.
How does it spread?
Malaria is caused by Plasmodium parasites, usually passed to people through the bite of an infected female Anopheles mosquito. It is not spread through ordinary contact with another person. Blood transfusions and contaminated needles can also transmit the infection.
Risk varies within countries and with the season and itinerary. Malaria-carrying mosquitoes mainly bite between dusk and dawn, so evening bite protection matters even when taking tablets.
Symptoms and possible complications
Early symptoms include fever, chills and headache and can resemble other infections. Severe malaria can cause confusion, seizures, breathing difficulty, severe anaemia and organ damage. Untreated falciparum malaria can deteriorate rapidly and become life-threatening.
Fever during travel or within a year of returning from a malaria-risk area needs urgent medical assessment. Tell the clinician where you travelled and which tablets you took. Do not dismiss malaria because you completed the course.
How an antimalarial medicine helps
an antimalarial medicine is an antibiotic that also suppresses malaria parasites. For prevention it must continue for four weeks after leaving the risk area. A daily routine matters, and sun sensitivity and irritation of the food pipe are practical considerations when choosing it.
Where it may be relevant
- Travellers to malaria-risk areas where an antimalarial medicine is recommended
- Longer stays where a low daily tablet cost may be helpful
- People who can reliably continue treatment for four weeks after exposure
Malaria risk map
Red highlights destinations with detailed malaria maps in our country guidance. Risk varies within countries and by itinerary; highlighting does not mean tablets are needed everywhere. Select a country for local advice and risk maps.
Dose schedules
The clinician will select the appropriate licensed schedule after reviewing age, health, previous doses and departure date.
Daily prevention
Adults and children aged 12 years or over
Take consistently with plenty of water; follow the dispensing instructions about food and interacting products.
Who may be eligible
- Adults and children aged 12 years or over when clinically suitable
- People without a contraindication or important interacting medicine
Who may not be eligible
- Pregnancy and breastfeeding
- Children under 12 years for malaria prevention
- People with tetracycline allergy; swallowing problems, oesophageal disease and interacting medicines require review
Potential side effects
- Nausea, indigestion, abdominal discomfort or diarrhoea
- Increased sensitivity to sunlight and risk of sunburn
- Oesophageal irritation if taken without enough water or immediately before lying down
Important risks and precautions
- Swallow with plenty of water while upright and do not lie down immediately afterwards
- Use strong sun protection and stop for urgent advice if a severe rash or allergic reaction develops
- No antimalarial is fully protective; fever requires urgent malaria testing
Clinical references