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FAQs: Advice on malaria prevention for travellers

This information sheet has been prepared by RITAM in response to many queries from the public about herbal medicines for the prevention of malaria. RITAM is an independent network of scientists and researchers working on traditional medicines and plant-based insecticides and insect repellents. It receives no commercial funding.

Can I take herbal medicine to prevent malaria?

The simple answer is “no”. So far there have been no clinical trials of any herbal medicines for the prevention of malaria. Falciparum malaria, commonest in Africa but also found throughout the world, can be fatal especially in non-immune travellers. It is not a risk to be taken lightly. Every year over 1000 travellers return to the UK with falciparum malaria, of whom about 10 die. These deaths are completely preventable.

There are some herbal medicines which are anecdotally used to prevent malaria. RITAM has prepared projects to evaluate these scientifically in proper clinical trials, but we are still looking for funding to support these projects.

Artemisia annua specifically is NOT recommended as a prophylactic. It was not used as a prophylactic in traditional Chinese medicine. The active compounds remain in the body for a very short time, so unless it is taken every 2-4 hours the levels in the bloodstream will not be sufficient to protect against parasites. Furthermore there is a risk of promoting the development of drug resistance if it is taken as prevention.

What about side-effects of modern drugs?

It is true that all drugs can have side-effects. Mefloquine (Lariam) has received particularly bad press because of neuropsychiatric side-effects. However if you have never had any mental health problems these are unlikely to affect you.

If you are concerned about these side-effects there are alternative drugs such as atovaquone-proguanil (Malarone) which have fewer side-effects. You should see your doctor to discuss this and get a prescription. Depending which drug you take, you may need to start up to 2 weeks before arriving in the malarious area.

Are there other methods of prevention?

Nothing will guarantee you will be 100% safe from malaria. You should take all possible precautions if travelling to a malarious area. As well as taking antimalarials, the most important thing you can do is to sleep under an insecticide-treated bednet. If it is not treated with insecticides it will not work because the mosquito can still land and bite you through the net if it is touching your skin.

Wear long-sleeved shirts and trousers in the evening and use insect repellent on exposed areas of skin. There does exist an effective plant-based repellent called Mosiguard which is based on essential oils of Eucalyptus citriodora. Good quality scientific research has shown this to be as effective as synthetic insect repellents. It also has the advantage of smelling nice and not burning through your plastic bags! You can buy this from most chemists in the UK.