Antimalarials are highly recommended for travellers going to endemic areas. While no regimen is 100 per cent effective, using chemoprophylaxis in conjunction with bite prevention gives significant protection. 

Chloroquine/proguanil

Chloroquine has been available to purchase for many years, but the emergence of chloroquine resistance in nearly all regions with P. falciparum means prophylaxis with chloroquine as a single agent is rarely appropriate. 

It remains useful for people visiting areas affected by other types of Plasmodium. There are also very few areas where P.falciparum is fully sensitive to proguanil so the agent is rarely recommended alone. 

Chloroquine and proguanil have increased efficacy when used in combination but, as many regions have chloroquine-resistant falciparum malaria, this is not recommended for travellers going to P. falciparum endemic areas. 

Proguanil is taken once daily, while chloroquine is taken once a week. Both are taken for one week prior to departure, continued throughout stay and for a further four weeks on departure. 

Maloff Protect 

The combination prophylactic antimalarial, atovaquone/proguanil, was previously only available via a prescription or patient group direction (PGD). Maloff Protect can now be recommended OTC for malaria chemoprophylaxis of P. falciparum in people who are aged 18 or over and who weigh 40kg (6st 4lbs) or more.