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Malaria Prevention for Children Residing in UK Boarding Schools - Advice for Parents  

Introduction

The advice given follows UK recommendations which are based on guidance from the World Health Organisation (WHO). Recommendations made by WHO are interpreted differently by individual countries so the advice given here may vary from normal practice in a boarding school residents own country.

UK Guidance

UK guidance is based around the principles of the A, B, C, D malaria prevention:

  • Awareness of Risk.
  • Bite avoidance.
  • compliance with malaria Chemoprophylaxis recommendations (malaria chemoprophylaxis refers to tablets that help to prevent malaria).
  • prompt Diagnosis and treatment.

Awareness of Risk

Children who live in the UK for most of the year will lose a significant degree of any natural immunity to malaria that they might have had in their home country. This can occur as early as one year after leaving the country of origin and is thought to be due to the lack of continuous exposure to malaria.

Information on people with malaria coming into the UK shows that travellers who go home to visit friends and relatives (VFRs) are a high risk group for acquiring malaria because they do not consider themselves to be at risk. VFRs are more likely to acquire malaria.

Bite Avoidance

  • To avoid mosquito bites wear clothing that covers as much of the body as possible such as long sleeved clothing and long trousers.
  • Mosquitoes may bite through thin clothing, so spray an insecticide or repellent on them. Insect repellents should also be used on exposed skin. DEET repellents are the most effective.
  • Burning pyrethroid coils and heating insecticide impregnated tablets all help to control mosquitoes.
  • If sleeping in an unscreened room, or out of doors, a mosquito net (which should be impregnated with insecticide) is essential.
  • Garlic, Vitamin B and ultrasound devices do not prevent insect bites.

Taking Malaria Chemoprophylaxis (tablets)

Dependant on the risk of malaria, chemoprophylaxis may be advised. UK recommendations for malaria chemoprophylaxis is based on information from the World Health Organisation (WHO).

While parents who live in malaria areas do not take chemoprophylaxis, it is advised for children returning home on holiday because they are more at risk having lost natural immunity to malaria.

  • It is strongly recommended that parents support the malaria advice and recommendations made in the UK including taking malaria chemoprophylaxis as advised. Where chemoprophylaxis is taken as directed, it will significantly reduce the risk of a child acquiring malaria.
  • Where possible children should take the tablets given to them in the UK as directed and should complete the course. It is best that tablets given in the UK are not substituted with other tablets at the destination.
  • Where tablets must be substituted (e.g. tablets are lost or side effects occur) then written information on the replacement tablets issued overseas should be provided for boarding school healthcare staff in the UK. This will be especially important if your child becomes ill on return to the UK, and needs treatment with other medication e.g. if malaria is suspected.

Prompt Diagnosis and Treatment

Parents who live in malaria areas may prefer to rely on prompt diagnosis and treatment of malaria rather than using chemoprophylaxis. While this approach may work in the home country, it may be less effective when the child returns to the UK e.g. if the child does not report symptoms of malaria early. UK advice therefore is for children to take malaria chemoprophylaxis as indicated where possible.

Malaria should be considered as the cause of any fever or flu-like illness and medical advice should be obtained  without delay.

 

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