The South African authorities have reviewed the risk areas for malaria transmission in the country, which has resulted in changes to guidance for UK travellers. The National Department of Health and the South African Malaria Elimination Committee undertook a review of its malaria guidelines and, additionally, risk areas have expanded in response to ongoing monitoring of malaria prevention and distribution.
Acknowledging this development, the Public Health England (PHE) Advisory Committee for Malaria Prevention (ACMP) has updated recommendations for UK travellers to South Africa. The ACMP guidelines are a practical guide for health professionals who advise travellers and can also be of use for travellers themselves.
Key changes to the 2015 guidelines include: updated guidance on the use of insect repellent and sun protection; clarification on the use of hydroxychloroquine; updated guidance on the use of anticoagulants with antimalarials; updated guidance on the use of doxycycline in epilepsy; and clarification of advice for travellers moving through areas where different antimalarials are recommended.
As always, travellers are advised to take bite avoidance measures throughout the year in all risk areas and follow the ABCD guide to preventing malaria: Awareness of the risk, Bite prevention, Chemoprophylaxis (taking antimalarials if appropriate for the area) and Diagnosis (seeking immediate medical care if a high fever develops more than one week after being in a malaria risk area).
The updated guidelines can be accessed here.