Between 2000 and 2015 the global incidence of malaria decreased by 37% overall, with the majority of cases in 2015 occurring in the WHO Africa and Asia regions (88% and 10%, respectively). Prompted by these changes, PHE's Advisory Committee on Malaria Prevention (ACMP) undertook an extensive review of the malaria recommendations for individual countries.
Changes to the risk level and/or malaria prevention recommendation have been made for 41 countries. In some areas, including some countries in Asia, parts of the Caribbean, and Central and South America, the malaria risk is now deemed to be below the threshold for which chemoprophylaxis is considered necessary.
In response to data from the PHE Malaria Reference Laboratory, which indicate a predominance of imported cases and almost all deaths originating from Africa, the PHE recommends that practitioners engage as much as possible with travellers planning to visit Africa to emphasise that the malaria situation there remains serious and requires rigorous application of preventive measures.
The guidelines continue to highlight that long-term travellers visiting friends or relatives run a higher risk of acquiring malaria than short-term travellers to the same location. Furthermore, the risk of developing severe or complicated malaria is higher in certain groups, such as the elderly (over 70 years old), the immunosuppressed, those with complex co-morbidities and pregnant women.
For people in these groups travelling to areas where the risk of malaria is considered to be low, antimalarials may be considered in exceptional circumstances.
The malaria prophylaxis recommendations for individual countries have been updated on the TravelHealthPro website and in the MIMS travel tables.