There is no travel vaccine for malaria, so prevention relies on avoiding mosquito bites and, for higher-risk destinations, taking antimalarial tablets. The right tablet depends on where you are going and your own health, so a short risk assessment before you travel is essential. At Wilmslow Pharmacy we provide malaria prevention advice and antimalarial tablets for travellers across Wilmslow and Cheshire.
What is malaria and where is the risk?
Malaria is caused by Plasmodium parasites, passed to people through the bite of infected female Anopheles mosquitoes, which bite mainly between dusk and dawn. Of the types that infect humans, Plasmodium falciparum causes the most severe illness and the majority of deaths, so it is taken seriously.
The greatest burden is in sub-Saharan Africa, which accounts for most cases worldwide, with Nigeria and the Democratic Republic of Congo alone making up a large share. Malaria is also present in parts of Asia, Central and South America, the Middle East and Oceania. Because risk varies sharply by country and even by region within a country, your specific destination is checked against current UK guidance at your appointment.
How do I prevent malaria? The ABCD approach
UK guidance sets out malaria prevention as four steps, known as ABCD. Together they give strong protection, though no single measure is completely effective on its own.
- A – Awareness of risk. Know whether your destination has malaria and how serious it is.
- B – Bite prevention. Avoid mosquito bites, especially between dusk and dawn.
- C – Chemoprophylaxis. Take the right antimalarial tablets correctly and complete the course.
- D – Diagnosis. Seek medical help promptly for any fever during or after travel, as malaria can be fatal if untreated.
How do I avoid mosquito bites?
Bite avoidance is the foundation of malaria prevention and matters even if you are taking tablets. Use an insect repellent containing DEET on exposed skin: 20% DEET protects for one to three hours, 30% for up to six hours and 50% for up to twelve hours, with no extra benefit above 50%. DEET is suitable from two months of age and in pregnancy at concentrations up to 50%, and should be reapplied after swimming and in hot, humid conditions. If DEET does not suit you, icaridin above 20% or lemon eucalyptus preparations are alternatives.
Cover up with loose, long-sleeved clothing and long trousers, ideally treated with permethrin, and sleep under an insecticide-treated bed net with a mesh no larger than 1.5mm if your room is not fully screened or air-conditioned. Air conditioning and mosquito coils also reduce bites.
Which antimalarial tablets are available in the UK?
Several antimalarials are used, and the choice depends on the parasite and resistance pattern at your destination and on your medical history. The main options and how they are taken are below. Your pharmacist confirms the right one for you.
| Tablet | How taken | Start before travel | Continue after leaving |
|---|---|---|---|
| Atovaquone with proguanil | Once daily | 1 to 2 days before | 7 days |
| Doxycycline | Once daily | 1 to 2 days before | 4 weeks |
| Mefloquine | Once weekly | 2 to 3 weeks before | 4 weeks |
| Chloroquine | Once weekly | 1 week before | 4 weeks |
Atovaquone with proguanil has the shortest post-travel course at seven days, which many short-trip travellers prefer. Doxycycline is a daily tablet that can cause sensitivity to sun. Mefloquine is taken weekly and started earlier so any side effects show up before you travel. Chloroquine is now of limited use because of widespread resistance. Each has its own cautions, so a proper assessment matters.
Are antimalarial tablets free on the NHS?
Generally no. Antimalarial tablets for travel are not usually available free on the NHS and are bought privately or, for atovaquone with proguanil, over the counter. Buying them through a pharmacy travel service like ours means you also get a proper risk assessment, the correct choice of tablet for your destination and advice on how to take it, rather than guessing.
When should I get my malaria advice and tablets?
Come in at least four to six weeks before you travel. That allows time to choose the right tablet, especially mefloquine which is started two to three weeks ahead so tolerability can be checked, and to combine malaria prevention with any travel vaccines you need. If your trip is sooner, it is still worth coming in, as some tablets can be started just one to two days before departure. See also our pre-travel health checklist and our full malaria prevention service.
Sources: TravelHealthPro (NaTHNaC) Malaria and Insect and tick bite avoidance factsheets; UKHSA/ACMP Guidelines for malaria prevention in travellers from the UK (2026), GOV.UK; NHS travel vaccinations.
Book your malaria consultation in Wilmslow
Same-day and next-day appointments usually available at Wilmslow Pharmacy.
