• Have a full travel plan for where/when you are going
   
• Ensure you are not pregnant or intending to conceive in the time the anti-malaria tablets are being taken
   
• Intend using other anti-mosquito precautions such as repellent sprays and bed nets. Further information is available below.
  
  Please Note: There may be a fee for the private prescription.

Protection Against Mosquito Bites

In the evenings:

• wear long sleeved shirts and long trousers.
   
• protect exposed limbs with a diethyltoltuamide-containing insect repellent and wear diethyltoltuamide-soaked ankle and wrist bands.
   
• Diethyltoltuamide (DEET) is the most effective repellent and there is vast experience of its use since 1957. It is estimated 200 million people use it each year DEET products should be applied with care to the face as it can irritate mucosal membranes (a skin test can be tried in advance if sensitive skin). Most DEET preparations remain effective on the skin only for 2-4 hours and therefore need effective and regular re-application.
   
• Children require similar measure, although there are rare reports of toxicity following excessive use of diethyltoltuamide in young children.
   
• Mosquitoes may bite through thin material. An insecticide (premetherin) has become available for spraying onto clothing and is believed to be effective for up to 2 weeks.

Sleep:

• Ideally sleep in fully air conditioned or screened accommodation.
   
• Rooms should also be sprayed with a knockdown insecticide every evening after sun down to eliminate insects that entered during the day.
   
• Where room cannot be made safe from insects, use a premetherin impregnated bed net. This provides much greater protection than an ordinary net. Kits for impregnating kits are available, a single treatment will last several months. Use an electrical pyrethoid vaporiser overnight where nets are not used.

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