Failure to provide chemoprophylaxis for malaria that is appropriate can cause serious morbidity and mortality for the patient.
The most common scenario is to provide a drug to which there is widespread resistance in the travel area. An example is to prescribe chloroquine alone to a traveler going to Sub-Saharan Africa.
Other errors may involve the dose, the duration of therapy and timing relative to the trip.
The consequences are more serious if:
(1) the patient is exposed to Pl. falciparum
(2) the patient is debilitated or at risk for severe disease
(3) the patient does not practice anti-mosquito behaviors (insect repellants, bed netting, etc)
In addition, the diagnosis of malaria may be delayed if the patient reports diligent chemoprophylaxis during the trip.
It is essential for a provider prescribing chemoprophylaxis to be aware of the patient's itinerary, the resistance patterns, and the current recommendations for prophylaxis.
