Common queries
Updated 17 June 2026
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This publication is available at https://www.gov.uk/government/publications/malaria-prevention-guidelines-for-travellers-from-the-uk-2026/common-queries
Once you get malaria, does it keep coming back?
Hypnozoite-induced relapses occur in vivax and ovale malaria but can be treated successfully and further relapses prevented. If the patient has received a full course of treatment with modern antimalarial drugs and has not been re-exposed to malaria, it is extremely unlikely that a history of recurrent febrile illness over a number of years is the result of chronic malaria.
Does oral doxycycline have an effect on oral contraception?
Doxycycline is a non-enzyme-inducing antibiotic. The College of Sexual and Reproductive Healthcare (formerly the Faculty of Sexual and Reproductive Healthcare) and the BNF advise that for combined oral contraceptives and for progestogen only oral contraceptives, additional precautions are not required when using non enzyme-inducing antibiotics. However, if the traveller suffers vomiting or diarrhoea, the usual additional precautions relating to these conditions should be observed.
Advice for travellers who discontinue chemoprophylaxis on or after return to the UK due to drug side effects; or who lost their supply; or whose trip has been extended beyond their supply of antimalarials
Atovaquone-proguanil combination preparation
If atovaquone-proguanil is discontinued before completing 7 days’ dosage post-return, no additional prophylactic drug need be recommended but the traveller must be warned of the increased risk of malaria compared with those who take the full dosage regimen. Increased vigilance is required and if the traveller becomes unwell in the first year after return, a blood test for malaria should be obtained without delay.
Suppressive prophylaxis (chloroquine, doxycycline, mefloquine)
If suppressive prophylaxis is discontinued before completing 4 weeks’ dosage post-return, no additional prophylactic drug need be recommended, but the traveller must be warned of the increased risk of malaria compared with those who take the full dosage regimen. Increased vigilance is required and if the traveller becomes unwell in the first year after return, a blood test for malaria should be obtained without delay.
References
Numbers refer to the complete list of references found in the References section.
51. Hill D. ‘Issues for long-term and expatriate travellers.’ In: Cook GC, editor. ‘Travel- associated disease: papers based on a conference organised by the Royal College of Physicians of London’ Royal College of Physicians 1995: page 101
136. Hughes C, Tucker R, Bannister B, Bradley D. ‘Malaria prophylaxis for long-term travellers’ Communicable Disease and Public Health 2003: volume 6, issue 3, pages 200 to 208
137. Luzzi GA, Peto TE. ‘Adverse effects of antimalarials’ Drug Safety 1993: volume 8, issue 4, pages 295 to 311
138. Lange WR, Frankenfield DL, Moriarty-Sheehan M, Contoreggi CS, Frame JD. ‘No evidence for chloroquine-associated retinopathy among missionaries on long-term malaria chemoprophylaxis’ The American Journal of Tropical Medicine and Hygiene 1994: volume 51, issue 4, pages 389 to 392
139. Overbosch D. ‘Post‐marketing surveillance: adverse events during long‐term use of Atovaquone/Proguanil for travelers to malaria‐endemic countries’ Journal of Travel Medicine 2003: volume 10, volume s1, pages S16 to S20