When people prepare for a trip abroad, travel vaccines tend to get top billing.
Antimalarial tablets, by comparison, are often treated as optional: something to skip to save money, or to “risk it” with instead.
Given the scale of malaria worldwide, that’s a risk worth reconsidering.
The real scale of the problem
According to the World Health Organization’s latest World Malaria Report, malaria caused an estimated 610,000 deaths worldwide in 2024, from around 282 million cases.
The burden falls overwhelmingly on the WHO African Region, which accounted for 95% of both cases and deaths that year, and children under 5 made up roughly 76% of malaria deaths in that region.
Despite efforts to combat malaria, WHO data shows the disease remains one of the top 10 causes of death in low income countries, alongside tuberculosis and HIV/AIDS.
In many malaria-endemic countries it is one of the leading causes of death.
That’s precisely the kind of country many UK travellers visit: for safaris, volunteering trips, family visits, or adventure travel across sub-Saharan Africa, South and Southeast Asia, and parts of South America.
The disconnect is this: people wouldn’t think twice about getting a yellow fever or hepatitis A vaccine before travelling to a country where these diseases are a risk, yet many skip or ration antimalarial tablets for a disease that kills far more people globally each year than most vaccine-preventable travel illnesses combined.
Where the risk is highest
Malaria risk isn’t evenly spread. The areas of greatest risk are:
Sub-Saharan Africa, home to around 95% of global malaria cases and deaths, and where the most dangerous parasite, Plasmodium falciparum, is most prevalent.
South and Southeast Asia, including parts of India, Bangladesh, Myanmar, Cambodia and Indonesia, where transmission is active in specific regions.
Parts of Central and South America, particularly the Amazon basin spanning Brazil, Peru, Colombia and Venezuela, though overall risk is lower than in Africa or Asia.
Risk can also vary significantly within a single country, by altitude, region and season, which is why it’s worth getting destination-specific advice rather than relying on a general assumption about a country as a whole.
Steps to reduce your risk
Because malaria is both preventable and treatable, the WHO frames prevention around avoiding mosquito bites and taking the right medicine, not one or the other. Practical steps include:
Take antimalarial medication as prescribed. The right tablets for your destination, taken exactly on schedule, before, during and after your trip (some need to be continued for up to four weeks after you return), are one of the most effective tools against infection.
Sleep under an insecticide-treated mosquito net in areas where malaria is present.
Use insect repellent containing DEET, IR3535 or Icaridin, particularly after dusk when the mosquitoes that carry malaria are most active.
Wear protective clothing, covering arms and legs in the evening, and use window screens or air conditioning where available.
Get advice early. Some antimalarial regimens need to start one to three weeks before you travel, so a visit to a travel clinic well ahead of your trip matters as much as packing your case.
Symptoms to watch for
Malaria symptoms usually appear within 10 to 15 days of being bitten by an infected mosquito, though this can occasionally be longer, particularly if you’ve been taking antimalarials.
Early symptoms are often mild and easy to mistake for a common illness such as flu:
- Fever
- Chills
- Headache
- Muscle aches and fatigue
Because these symptoms are so non-specific, it’s easy to dismiss them, but malaria can progress quickly.
Severe symptoms, which require emergency care, include:
- Extreme tiredness or confusion
- Seizures or convulsions
- Difficulty breathing
- Dark or bloody urine
- Jaundice (yellowing of the skin or eyes)
- Unusual bruising or bleeding
Left untreated, the most dangerous form of malaria can progress from mild symptoms to severe illness within 24 hours.
What to do if you develop symptoms
If you develop a fever or flu-like symptoms during or after travel to a malaria risk area, whether that’s weeks or up to a year after you return, treat it as a medical priority:
- Seek medical attention urgently, and tell the doctor exactly where and when you travelled. Malaria should be considered in anyone with a fever who has been to a risk area, even if antimalarials were taken correctly.
- Ask specifically about a malaria blood test. Malaria isn’t always the first thing a GP or out-of-hours service will consider if travel history isn’t mentioned, so be explicit about your itinerary.
- Don’t wait it out. Because P. falciparum malaria can become severe within a day, early diagnosis and treatment make a significant difference to outcomes.
- Go straight to A&E if you develop any of the severe symptoms listed above.
Get properly protected before you go
Antimalarial medication isn’t a box to tick alongside your travel vaccines: for many destinations, it’s one of the most important things you’ll pack.
Our team at McMinns Pharmacy can advise on the right antimalarial for your destination and get you set up before you travel.
Visit our Travel Clinic page to arrange your antimalarial medication today.