When should travelers begin malaria prophylaxis?
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Travelers should start on chloroquine 1 to 2 weeks before entering an area without chloroquine resistance (strength of recommendation [SOR]: C, based on expert opinion). In areas with chloroquine-resistant Plasmodium falciparum, travelers will need to take atovaquone/proguanil, doxycycline, or primaquine 1 day before entering the area, or mefloquine 2 to 7 weeks before travel (SOR: B, based on prospective patient-oriented outcomes and expert opinion). Before prescribing medications, determine malaria risk and sensitivity of Plasmodium species by country at wwwn.cdc.gov/travel/yellowBookCh5- MalariaYellowFeverTable.aspx (SOR: C, based on patient-oriented expert opinion).
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