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New Italian guidelines for malaria prophylaxis in travellers to endemic areas

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Abstract

Background and Methods

As a consequence of the rapid evolution of malaria prophylaxis recommendations throughout the world, the Italian Society of Tropical Medicine (SIMET—Società Italiana di Medicina Tropicale) has set up a working group in charge of preparing a new national guideline. Other scientific societies interested in the topic were also involved in the project.

Results and Conclusions

The group stated that awareness about malaria risk and characteristics, as well as protection from mosquito bites, are recommended for all travellers visiting malaria-endemic countries. The risk and benefit of malaria chemoprophylaxis must be carefully balanced before prescribing drugs: the disease-related risk must outweigh the possibility of drugs’ side effects. As a general rule, malaria pills are the first choice for travellers to high-risk areas, such as sub-Saharan Africa, Eastern India, Myanmar, Eastern Indonesia, Papua New Guinea and, with some limitations, South-East Asia, and the Amazon part of Venezuela, Guyana and French Guyana. However, several other factors, such as itinerary, season, duration of trip, availability of insect bite protection, pre-existing conditions and compliance, must be taken into account. In low-risk areas, stand-by emergency treatment is the first option. In minimal-risk areas and in Plasmodium vivax areas, a prompt diagnosis only is advised (Central America, South America outside the Amazon basin, Middle East, China, Thailand, Nepal). Recommendations may be modified when particular groups of travellers are concerned, such as long-term residents, visiting friends and relatives, patients with pre-existing conditions, pregnant women and children.

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Conflict of interest

GC has received grants for speaking by Sigma-Tau; FC has acted as PI for a Sigma-Tau-sponsored trial; IEH, FG, AM, GN, RR, and AR declare no conflict of interest.

Author information

Authors and Affiliations

  1. Travel Medicine Unit, Department of Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy

    G. Calleri

  2. University Division of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy

    F. Castelli & A. Matteelli

  3. Department of Infectious Diseases, Spedali Civili General Hospital, Brescia, Italy

    I. El Hamad

  4. Centre for Tropical Diseases, Sacro-Cuore Hospital, Negrar, Verona, Italy

    F. Gobbi & A. Rossanese

  5. Travel Diseases Prevention Unit, Department of Prevention, ULSS 20, Verona, Italy

    G. Napoletano

  6. Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy

    R. Romi

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  1. G. Calleri
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  2. F. Castelli
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  3. I. El Hamad
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  4. F. Gobbi
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  6. G. Napoletano
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  7. R. Romi
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  8. A. Rossanese
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Corresponding author

Correspondence to G. Calleri.

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Calleri, G., Castelli, F., El Hamad, I. et al. New Italian guidelines for malaria prophylaxis in travellers to endemic areas. Infection 42, 239–250 (2014). https://doi.org/10.1007/s15010-013-0563-3

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  • DOI: https://doi.org/10.1007/s15010-013-0563-3

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