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Malaria terminal prophylaxis — DTM&H MCQ

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ModerateMalariaMalaria terminal prophylaxisDTM&H

A 41-year-old soldier returns after prolonged deployment in Papua New Guinea. He used suppressive prophylaxis correctly but is at continuing risk from relapsing Plasmodium vivax and has normal G6PD activity. What is the most appropriate prophylaxis?

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Correct answer: D — Primaquine terminal prophylaxis

Primaquine terminal prophylaxis is the single best answer because primaquine can eradicate latent hypnozoites after high-risk exposure when G6PD status is normal. Chloroquine weekly prophylaxis is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that suppressive drugs prevent blood-stage disease but do not remove vivax or ovale liver stages.

Reference: WHO Guidelines for malaria, 2025; UKHSA Malaria prevention guidelines for travellers from the UK, 2025; CDC Yellow Book 2026