Guidance

General issues

Updated 17 June 2026

The United Kingdom Malaria Expert Advisory Group (UKMEAG) prophylaxis guidelines are intended for UK-based visitors to malaria-endemic areas and may not be appropriate for use by those residing in endemic areas.

We recommend health professionals use one resource for country specific malaria recommendations to optimise consistency of advice. Healthcare professionals working in the UK are advised to use the UKMEAG guidelines as their preferred source of guidance for malaria prevention. They are also available on the NaTHNaC website TravelHealthPro.

While these guidelines deal with malaria, malaria prevention is only one aspect of pre-travel advice. An overall risk assessment-based package of travel health advice should be provided to the traveller. Guidance on general travel risk assessment can be obtained from NaTHNaC.

For doctors and nurses providing travel services in England who are regulated by the Care Quality Commission (CQC), the CQC website states that GP practices that provide travel health services can also offer advice, including preventing malaria.

In these guidelines, which have been specifically developed for travellers from the UK, there are a small number of instances where the advice given differs from that in guidelines from other countries or the World Health Organization (WHO). This is because travellers from the UK do not usually visit all possible localities of malaria-endemic countries and may not visit the same localities as travellers from other countries. Many travellers from the UK who enter malaria- endemic countries are visiting friends and relatives in localities from which people tend to migrate to the UK. They do not therefore suffer the same patterns of malaria exposure as permanent residents or tourists or those visiting for other reasons.

How to give the advice

Emphasise to the traveller the ABCD of malaria prevention:

• Awareness of risk
• Bite prevention
• Chemoprophylaxis
• Diagnose promptly and treat without delay

Emphasise that while no regimen is 100% effective, the combination of preventive measures advised will give significant protection against the potentially severe consequences of malaria.

Make use of visual aids, especially malaria distribution maps, and show examples of the preventive measures advised, such as aids to bite prevention.

Based on individual risk assessment, discuss the choices of chemoprophylaxis regimens and their individual advantages and disadvantages, including cost.

Provide the traveller with written information on malaria and its prevention. UKHSA has information leaflets on mosquito bite avoidance and travelling abroad to visit friends and relatives in English, Arabic, Bengali, French, Gujarati, Hausa, Igbo, Punjabi, Spanish, Swahili, Urdu, Xhosa and Yoruba, and in BSL, large print, braille, and Easy Read. These may be downloaded, photocopied and distributed free of charge. English versions are also available to order.

Guidance videos can be found on YouTube:

• visiting friends and relatives abroad
• mosquito bite avoidance

Medical history of the traveller

As part of a stringent individual risk assessment it is essential that a full clinical history is obtained, detailing current medication including those drugs prescribed by hospitals which may not appear on GPs’ drug lists for repeat prescriptions, significant health problems and any known drug allergies.

Safe and effective malaria prevention requires a sound knowledge of the medical history of the traveller. When patients seek pre-travel advice in primary care, this information will be available from their own practice records but in the case of specialist travel clinics, malaria prevention advice may be sought at the first attendance. The General Medical Council states:

If you are not the patient’s general practitioner and you accept a patient for treatment without a referral from the patient’s practitioner, then you must: (a) explain to the patient the importance and benefits of keeping their general practitioner informed and (b) inform the patient’s general practitioner unless the patient objects.

UKMEAG suggests that in all scenarios where advice is given, a written record of the malaria prevention measures advised is given to the traveller so that they may pass it on to their GP. A template for risk assessment and summary of advice given is provided in Appendix 2, which can be used for gathering the information required for risk assessment when advising on malaria prevention. It may be adapted for the particular circumstances of individual clinics.