Malaria prevention — planning ahead for your trip
Reviewed by the My London Pharmacy clinical team, Michelle Chuku, Pharmacist Independent Prescriber
·29 July 2026
·7 min read
Quick answer
Malaria is a serious illness spread by mosquito bites in many tropical regions. It is preventable with the right planning: avoid bites, take antimalarial tablets where recommended, and know the warning signs. Because some treatments start before you travel, it is best to seek advice several weeks ahead.
What malaria is and how it spreads
Malaria is a serious and sometimes life-threatening infection caused by a parasite carried by certain mosquitoes. It is passed to people through the bite of an infected female mosquito, which typically bites between dusk and dawn. Malaria is found in many tropical and subtropical parts of the world, including large areas of sub-Saharan Africa, South and Southeast Asia, parts of the Middle East, and Central and South America.
Once the parasite enters the bloodstream, it travels to the liver and then infects red blood cells, which is what leads to the illness. The risk to travellers varies widely depending on the country, the region within it, the altitude, the time of year and the type of trip. Malaria does not spread directly from person to person like a cold. The reassuring point is that, with the right preparation, it is largely preventable, and thousands of people travel safely to affected regions every year by taking sensible precautions.
Knowing your risk before you go
The first step in prevention is understanding the specific risk for your destination. Two people travelling to the same country can face very different levels of risk depending on exactly where they are going, whether they are visiting rural or urban areas, the altitude of their destination, how long they are staying and the season in which they travel.
Up-to-date, country-specific guidance is important, as recommendations can change over time. A clinician or pharmacist can help you check the risk for your particular itinerary and decide what precautions are appropriate. This assessment considers your destination alongside your medical history, any medicines you take, allergies, and who is travelling with you, including children or anyone who is pregnant, since recommendations can differ for these groups. Taking time over this step means the rest of your prevention plan is built on the right foundations.
Avoiding mosquito bites
Preventing bites is the foundation of malaria prevention, and it matters even if you are also taking antimalarial tablets, because no single measure is completely reliable on its own. The mosquitoes that carry malaria are most active between dusk and dawn, so evening and overnight protection is especially important. Practical measures include:
- Use an effective insect repellent on exposed skin, reapplying as directed throughout the evening and night.
- Cover up with long sleeves and trousers after dark, ideally in loose, light clothing.
- Sleep under a mosquito net, ideally one treated with insecticide, if your room is not properly screened or air-conditioned.
- Use screens or air conditioning where available to keep mosquitoes out of your sleeping area, and check for gaps around windows and doors.
- Consider treating clothing or gear with suitable insecticide products for higher-risk trips.
These simple steps also reduce your risk of other insect-borne illnesses that share the same regions, so they are worth following consistently throughout your trip rather than only on the first night.
Antimalarial tablets and prevention
For many destinations, antimalarial tablets are recommended in addition to avoiding bites. Several options exist, and the right choice depends on where you are going, the local pattern of malaria and any resistance, how long you will be away, your health, your age, whether you are pregnant, and any other medicines you take. Some are taken daily and others weekly, and they differ in when you need to start and stop them, as well as in their possible side effects.
Importantly, many antimalarials need to be started before you enter a malaria area and continued for a period after you leave, because the parasite has stages that the tablets need time to cover. Skipping doses or stopping early can leave you unprotected. Because no preventive approach is completely guaranteed, tablets are used alongside bite-avoidance measures rather than instead of them. A clinician can advise which option may be suitable for you as part of a consultation, subject to your individual circumstances, and explain exactly how and when to take it so that it works as intended.
Special considerations for some travellers
Certain travellers need extra thought when planning malaria prevention. People who are pregnant, young children, older adults and those with long-term health conditions may be more vulnerable if they contract malaria, and the choice of preventive tablets can be affected by pregnancy, age, kidney or liver problems and interactions with existing medicines.
Travellers visiting friends and relatives in their country of origin are also worth a special mention, as they sometimes assume they are still protected from earlier exposure. Any natural resistance fades over time, so returning travellers need the same careful precautions as anyone else. If any of these situations apply to you, it is especially important to seek personalised advice, as a clinician can weigh up the options and recommend the safest and most suitable approach for your circumstances.
Recognising the symptoms
Even with careful precautions, it is important to know the warning signs, because no prevention is perfect and malaria can develop after you return home. Symptoms often resemble flu and can include:
- A high temperature, sweats and chills
- Headaches and aching muscles
- Tiredness and a general feeling of being unwell
- Nausea, vomiting or diarrhoea
Symptoms usually appear between a week and several weeks after being bitten, but can occasionally develop months later, which is why the connection to travel is sometimes missed. Malaria is a medical emergency, and prompt diagnosis and treatment make an enormous difference to the outcome. If you become unwell with these symptoms during or after travel to a malaria area, seek medical help urgently and be sure to mention where you have been and when, even if you took preventive tablets.
Malaria prevention as part of travel health
Malaria prevention rarely sits on its own. It is usually one part of a wider set of travel health considerations that are worth thinking about together before a trip. Depending on your destination, other precautions around food and water hygiene, insect-borne illnesses and general safety may also be relevant, and it makes sense to review them in one go rather than piecemeal.
Approaching your travel health as a whole helps you avoid gaps and reduces last-minute stress. It also means you can organise everything you need, from repellents and nets to any tablets and a small health kit, in good time and with a clear understanding of how to use each one. A pharmacist or clinician can help you see the full picture for your particular journey, taking account of where you are going, what you will be doing and your personal circumstances, so that malaria prevention fits neatly alongside your other preparations rather than being treated in isolation.
Why planning ahead matters
Malaria prevention works best when it is arranged in good time. Because some antimalarial tablets need to be started before departure, and because you may want to allow time to check that an option suits you and to get used to taking it, it is sensible to seek advice several weeks before you travel rather than at the last minute. Leaving it too late can limit your choices.
Planning early also gives you time to organise repellents, nets and any other travel health needs in one go, and to think through practical questions such as where you will sleep and how you will keep to your tablet schedule. If you have a trip coming up, the My London Pharmacy team can review your destination and circumstances and help you put the right prevention plan in place with confidence, so you can focus on enjoying your travels.
Frequently asked questions
How far in advance should I plan malaria prevention?
It is best to seek advice several weeks before you travel, as some antimalarial tablets need to be started before you arrive in a malaria area and continued after you leave.
Do I still need to avoid bites if I take antimalarial tablets?
Yes. No preventive measure is completely guaranteed, so tablets are always used alongside bite-avoidance steps such as repellent, covering up and sleeping under a net.
Are all destinations the same risk?
No. Risk varies by country, region, altitude, season and type of trip, so country-specific advice for your exact itinerary is important. A clinician can help you check this.
When do malaria symptoms appear?
Symptoms usually develop between a week and several weeks after being bitten, but can occasionally appear months later, even after you have returned home.
What should I do if I feel unwell after travelling?
Malaria is a medical emergency. If you develop flu-like symptoms during or after travel to a malaria area, seek urgent medical help and tell them where you have been.
I grew up in a malaria area. Am I still protected?
Any natural resistance fades over time once you no longer live there, so returning travellers need the same careful precautions as anyone else visiting the region.