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Malaria Prophylaxis — SCE Infectious Diseases MCQ

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EasyTravel Medicine & VaccinationMalaria ProphylaxisSCE Infectious Diseases

A 30-year-old woman presents to the travel clinic planning a 4-week trip to rural sub-Saharan Africa. She is fit and well, takes no regular medications, and is not pregnant. She wants malaria prophylaxis. Proguanil is no longer available in the UK. What is the most appropriate chemoprophylaxis?

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Correct answer: D — Atovaquone/Proguanil (Malarone) started 1–2 days before travel

For travel to sub-Saharan Africa (high-risk P. falciparum area), three options are recommended: Atovaquone/Proguanil, Doxycycline, or Mefloquine. Standalone Proguanil has been discontinued in the UK. Atovaquone/Proguanil (Malarone) is generally well-tolerated with the advantage of short pre-travel lead-in (1–2 days before) and short post-travel course (7 days after). Chloroquine monotherapy is NOT effective in Africa due to widespread P. falciparum chloroquine resistance.

Reference: UKHSA/UKMEAG 2024 – Malaria prevention guidelines for travellers from the UK