What Is Malaria and Why Is It a Risk for Travellers?
Malaria is one of the most serious infectious diseases in the world and a significant cause of illness and death among international travellers who fail to take adequate precautions. Caused by Plasmodium parasites — most commonly Plasmodium falciparum in sub-Saharan Africa — and transmitted through the bite of an infected female Anopheles mosquito, malaria can cause severe fever, chills, vomiting, and, in serious cases, organ failure or death. Despite being both preventable and treatable, hundreds of thousands of people die from malaria each year, and a significant proportion of cases in the UK are imported by travellers returning from affected regions.
At Travel Clinic Bedford, operated by Goldharts Pharmacy, we take malaria prevention seriously. Our dedicated travel health team provides personalised malaria prevention advice in Bedford to help every traveller understand their risk and take the right steps to protect themselves. Whether you're going on a safari in Kenya, volunteering in West Africa, or visiting family in India or Pakistan, knowing your malaria risk and how to manage it is essential before you travel.
Where Is Malaria a Risk?
Malaria is endemic in over 90 countries across sub-Saharan Africa, South Asia, Southeast Asia, Central and South America, and parts of the Middle East and Pacific. However, the level of risk varies enormously by destination, season, altitude, and type of travel. Sub-Saharan Africa — particularly countries such as Nigeria, Uganda, Cameroon, Tanzania, and Kenya — carries the highest global burden of malaria, and travellers to this region face significant risk, especially in rural or remote areas. In contrast, many popular tourist destinations in Southeast Asia, such as Bali or urban Thailand, carry a much lower risk.
The species of malaria parasite also differs by region. Plasmodium falciparum, the most dangerous species, is predominant in Africa. Plasmodium vivax is more common in South Asia and Latin America. Understanding which species is present in your destination matters because different antimalarial medications are more effective against different species. This is another reason why consulting a qualified travel health professional is so important — a one-size-fits-all approach is simply not good enough when it comes to malaria prevention.
The ABCD of Malaria Prevention
Travel health professionals commonly refer to the "ABCD" framework for malaria prevention — a straightforward approach that covers all the key steps travellers need to take.
A — Awareness of risk. Understanding whether your destination carries a malaria risk, and what level of risk you are personally facing, is the crucial starting point. Factors including your exact destination, planned activities, time of year, accommodation type, and personal health history all influence your level of risk.
B — Bite prevention. No antimalarial medication is 100% effective on its own, which makes bite avoidance an absolutely essential part of malaria prevention. You should use a DEET-based insect repellent on all exposed skin from dusk to dawn, wear loose-fitting, long-sleeved clothing in light colours during evening and night hours, sleep under an insecticide-treated mosquito net if your accommodation is not air-conditioned or adequately screened, and consider treating clothing and bed nets with permethrin for additional protection.
C — Chemoprophylaxis (antimalarial tablets). Taking an appropriate antimalarial medication before, during, and after your trip significantly reduces your risk of contracting malaria. The most commonly prescribed antimalarials for travellers from the UK include atovaquone/proguanil (Malarone), doxycycline, and mefloquine (Lariam). Each has its own regime, side-effect profile, and suitability criteria. Our team at Travel Clinic Bedford will help you choose the right antimalarial for your individual circumstances.
D — Diagnosis. If you develop a fever, headache, muscle aches, or flu-like symptoms during or within 12 months of returning from a malaria-risk destination, you must seek urgent medical attention and inform the healthcare provider of your recent travel history. Malaria can progress rapidly and become life-threatening if left untreated, so prompt diagnosis is vital. Do not wait to see if symptoms resolve on their own.
Which Antimalarial Is Right for You?
Choosing the right antimalarial medication requires careful consideration of your destination, itinerary, personal health, any medications you currently take, and your planned length of travel. Here is a brief overview of the main options available.
Atovaquone/Proguanil (Malarone) is one of the most commonly prescribed antimalarials for travellers. It is taken once daily, starting one to two days before arrival in the malaria zone, continuing throughout the trip, and for seven days after leaving. It is generally well-tolerated, though it should be taken with food to minimise gastrointestinal side effects. It is suitable for most adults and children weighing over 11kg, but is not recommended for pregnant women or those with severe renal impairment.
Doxycycline is a broad-spectrum antibiotic that is also effective as an antimalarial. It is taken once daily, starting two days before travel, and continued for four weeks after returning. One advantage of doxycycline is its lower cost compared to Malarone. However, it can cause photosensitivity and it cannot be used by pregnant women or children under 12.
Mefloquine (Lariam) is taken once weekly, making it convenient for long trips. However, it requires a longer lead-in period — starting two to three weeks before departure — and is associated with neuropsychiatric side effects in some people, including vivid dreams, anxiety, and mood changes. A neuropsychiatric screening assessment is required before prescribing mefloquine.
Malaria in Pregnancy and Children
Pregnant women face an increased risk of severe malaria and its complications, including preterm delivery, low birth weight, and maternal death. Ideally, travel to high-risk malaria areas should be avoided during pregnancy. If travel is unavoidable, careful specialist guidance is essential. At Travel Clinic Bedford, we provide careful risk assessment for pregnant travellers and can advise on the safest approach in your individual circumstances.
Children are also particularly vulnerable to severe malaria. Parents travelling to malaria-endemic regions with young children should ensure appropriate antimalarial cover is in place, along with rigorous bite avoidance measures. Doses of antimalarial medication are calculated based on a child's weight, and not all medications are suitable for all ages. Please discuss this with our team well in advance of your trip.
Travellers Visiting Friends and Family
One of the groups at highest risk of imported malaria in the UK is so-called "VFR" (visiting friends and relatives) travellers — people who travel to malaria-endemic regions to visit family or friends in their country of origin. VFR travellers are often less likely to seek travel health advice than other tourists, sometimes because they believe they have a degree of residual immunity from childhood. This is a dangerous assumption: immunity to malaria is short-lived and incomplete, and adults who have been living in the UK for several years will have very little protection. If you are travelling to visit family in Africa, South Asia, or any other malaria-risk region, please make sure you seek travel health advice and take appropriate precautions.
Beyond the Tablets: Staying Safe from Mosquito Bites
It bears repeating: antimalarial tablets alone are not enough. Even if you take your medication correctly and consistently, there remains a residual risk of malaria. This is why bite prevention must always accompany chemoprophylaxis. Use an effective insect repellent — products containing at least 50% DEET are recommended for high-risk destinations. Apply repellent after sunscreen, not before, and reapply regularly, especially after sweating or swimming. In accommodation without air conditioning, sleep under a permethrin-treated mosquito net, ensuring it is tucked in securely under the mattress with no gaps. Avoid being outdoors during peak mosquito activity times — dusk and dawn — and if you must be outside, ensure you are covered up with long, light-coloured clothing.
Your Malaria Prevention Consultation at Travel Clinic Bedford
When you book a malaria prevention consultation at Travel Clinic Bedford, our travel health advisors will take a full travel and medical history, assess your personal risk level, recommend the most appropriate antimalarial regimen, provide detailed advice on bite avoidance, and ensure you know exactly what to do if you develop any symptoms. We also provide guidance on our wider range of travel health services — including travel vaccinations in Bedford and altitude sickness advice for those heading to mountainous destinations.
As part of Goldharts Pharmacy, we combine pharmacist expertise with travel medicine knowledge to give you comprehensive, trustworthy advice in a friendly, welcoming environment. Our aim is always to help you travel safely and return home healthy.
Book Your Malaria Prevention Appointment in Bedford
Don't leave malaria prevention to chance. The consequences of contracting malaria can be severe, but with the right preparation it is largely preventable. Our expert travel health team at Travel Clinic Bedford is here to help you every step of the way — from choosing the right antimalarial to mastering bite avoidance strategies.
Appointments are available at times to suit you, and we recommend booking at least six to eight weeks before your departure date to allow time for any necessary preparations. Book your malaria prevention appointment now and take the first step towards a safe and healthy journey.