Around 10,000 cases of malaria are imported into Europe each year, with a mortality rate of 1.1% in patients with Plasmodium falciparum malaria. About 2,000 cases are reported each year in the United Kingdom (United Kingdom).

Malaria imported to Europe is mainly due to P.falciparum and accounts for more than 50% of all cases. In some countries, the proportion of P.falciparum infections is high - from 70 to 80% of cases.

About 70% of P.falciparum infections brought to the UK in the past decade have been with ethnic travelers. About 2/3 of them came from West Africa, 20% from East Africa and the rest from South and Central Africa. A recent analysis of P.falciparum infection in the UK found that three quarters of the cases were in London and that 64% of non falciparum malaria cases had occurred in travelers to South Asia. The relative risk of P.falciparum infection among ethnic travelers to West Africa is 4 times higher than that of ordinary tourists visiting this region. Likewise, the risk of malaria among ethnic travelers in East Africa and the Indian subcontinent is respectively 3 and 8 times higher than for tourists traveling in the same regions.

The type of trip is associated with risk: during a hike, the risk is higher than accommodation in air-conditioned and well-closed urban hotels. Personal protection against mosquito bites and preventive measures reduce the risk of infection. The cumulative risk of contracting malaria is proportional to the length of stay in the transmission area. A higher risk of transmission is observed during the rainy season.

The incidence of P.falciparum malaria among permanent residents returning to the United Kingdom who have visited popular places in sub-Saharan Africa ranges from 10 to 216 cases per 10,000 visits.

When comparing the risk of infection, an entomological inoculation coefficient (EIC) is often used to quantify the risk to travelers. This is the annual number of bites of infectious mosquitoes received by a person. The EIC in eastern Thailand is around 0.91, which is approximately equivalent to one bite of an infectious mosquito per year, while in Tanzania it is 667, which is equivalent to two bites per night.. In Kenya, the EIC ranges from 17 to 299.3 (one bite in 3 weeks - one bite per night). On the coast, the risk of transmission is lower than in the continental areas.

Malaria prevention is based on the abbreviation "ABCD": Sensitization (awareness - risk awareness), Stings (stings - prevention and avoid mosquito bites), Compliance (compliance - following appropriate chemoprophylactic recommendations) and Diagnosis (diagnosis - rapid diagnosis and immediate treatment). The choice of appropriate antimalarials is based on the risk of infection during the trip, the possibility of side effects from chemoprophylaxis, the desire to maintain health, the observance of the traveler and the cost of treatment. Informing patients about the risk of malaria and recognizing the symptoms are the priority objectives of the council before traveling.

Personal protection against Anopheles bites is based on the use of topical repellents during bite periods (from dusk to dawn) and the use of elongated clothing to protect exposed skin. The activity of repellents is variable and depends on many factors. The composition of the repellant is crucial because it affects the duration of the repellent effect. The increased stability of the composition provides protection for more than 8 hours. The concentration of the active compound also determines the duration of the repelling effect: 30% provides approximately 5 hours of protection and a concentration greater than 50% - more than 8 hours. High concentrations (above 30%) should be avoided for newborns and children. The use of insecticide sprays, sprays and nets should also be encouraged. Sealed air-conditioned rooms are an environment in which insects cannot enter, and therefore mosquito measures, in addition to spraying aerosols to clean the room, are unnecessary. Heated spray mats clean the room of insects in 30 minutes and remain effective for 6 hours. Smoking coils impregnated with pyrethrin derivatives are a less effective and cosmetically less acceptable method. In non-air-conditioned and leaky rooms, mosquito nets saturated with peritrin are a very effective system to prevent bites during sleep. Reduced adherence to one or more of these methods (35 to 70%) in travelers considerably increases the risk of an infectious bite. Optimal protection is obtained if the methods are used in combination. Vitamin B6 inside, garlic and an electric horn are unproven methods to prevent bites.

Due to the prevalence of drug-resistant P.falciparum in Africa, mefloquine, doxycycline or atovaquone / proguanil are preferred for travelers to these regions. Chloroquine and proguanil in combination have a prophylactic efficacy of less than 50%, which is no longer sufficient for most regions of sub-Saharan Africa. The adverse reaction profile of preventive regimes greatly affects the welcome and observance of travelers. More than 20% of travelers on chemoprophylaxis report associated problems (vivid or unusual dreams, less often depression and anxiety when taking mefloquine). Severe psychiatric manifestations (convulsions, psychosis, severe depression) occur with a frequency of 1/10000.

Early diagnosis is a critical factor in the favorable outcome of P.falciparum malaria. The best opportunity to provide an early diagnosis is a pre-trip consultation, during which the traveler is informed of the symptoms of malaria and the need to see a doctor immediately.

Travelers traveling to areas at low risk of malaria transmission may be advised to take their medication with them to the store instead of using chemoprophylaxis. This approach is used effectively with one of the personal diagnostic kits for falciparum malaria, which should not, however, replace on-site professional medical care.