Long term expats in countries with endemic malaria will be familiar with the risks, preventative measures and treatment of the disease. But for those
new to an area or travelling into a malarial region for the first time deciding the best course of action can be confusing. In these tips for first timers Dr Jace Clarke says prevention is better than cure and taking local advice is often the best course of action.

Malaria is a devastating disease which causes serious illness and can even be fatal if not treated. It’s caused by parasites which live and replicate in red blood cells and is transmitted by the bite of an infected female Anopheles mosquito.

The incidence of malaria varies between countries and even in those where the disease is prevalent there are areas which can be safe and others which are high risk. As a general rule the threat is greater in rural sub tropical areas than it is in built up neighbourhoods. Before you travel check on-line to find out the risks and which places to avoid.

The best way to avoid contracting malaria is to avoid being bitten in the first place. Mosquitoes tend to bite from dusk to dawn, so take greater care at night:

•   Wear light coloured clothing and cover arms and legs.
•   Avoid sweet smelling perfumes and aftershaves.
•   Cover exposed skin with insect repellent.
•   Burn a spiral mosquito repellent coil or a citronella candle.
•   Use a mosquito net at night and consider impregnating it with a recognised repellant.

There are many different types of anti-malarial drugs that can help to prevent the disease if taken regularly, but some have unpleasant side-effects. In a few areas the mosquitoes have developed resistance to some drugs and there is also concern about the implications of taking the drugs long term.

The decision about whether to take anti-malarial drugs involves a personal risk-benefit assessment, depending on the areas to be visited and the effect the drugs have on you. Some people experience significant side effects and others virtually none. Before visiting a new area check carefully on travel advice websites and with local medical practitioners to find out the risk and establish the most appropriate anti-malarial drugs for the region. If you are staying for a long time talk to other expats to find out local best practice and remember that advice can be 'fine-tuned' by the experience of doctors in the region.

The bottom line is to understand the risks, take sensible precautions and talk to local medical practitioners. The risks are perfectly manageable and shouldn’t put you off visiting a new country – but if you develop flu-like symptoms or are at all concerned that you may have contracted malaria seek treatment immediately.