What should you know about long term malaria prophylaxis?

Malaria prevention tablets reduce the chance of infection but do not replace protection from mosquito bites. The suitable medicine depends on the country and areas visited, season, length of stay, local resistance, pregnancy plans, allergies, kidney or liver health, and other medicines. Some options begin before departure and continue after leaving; the schedule differs between medicines. No tablet prevents every infection, so fever or flu-like illness after exposure still needs medical attention.

Arrange a travel health consultation early enough to review the itinerary and medical history. Take the medicine exactly as prescribed, use reminders, and keep it in its original labelled packaging. Use insect repellent, long sleeves, trousers, screened or air-conditioned rooms, and an insecticide-treated bed net where appropriate. Ask what to do after vomiting a dose or missing one; do not double doses unless a clinician specifically instructs you.

Get urgent medical advice for fever, chills, sweats, headache, marked weakness, confusion, breathing difficulty, jaundice, or repeated vomiting during travel or after returning from a malaria area. Tell the clinician where you travelled and that you used, or may have missed, prophylaxis. Seek advice promptly for a severe rash, facial swelling, mood or behaviour changes, unusual bruising, or other concerning medicine reaction.

Which malaria prophylaxis suits my itinerary and medical history? When should I start and stop it? What should I do if I miss or vomit a dose? Which symptoms need urgent testing after I return?