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Feature Article

Malaria. How global advances in control and treatment have changed the game

HARIN KARUNAJEEWA

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© NECHAEVKON/SHUTTErSTOCK.COM
© NECHAEVKON/SHUTTErSTOCK.COM

Abstract

Significant progress in the global fight against malaria means that overseas travellers are now much less likely to acquire this potentially fatal disease. Improved treatments also allow a simpler ‘one-size-fits-all’ approach for treating the diminishing number of cases of malaria in Australia.

Key Points

  • Renewed efforts to control and eliminate malaria throughout the world have been outstandingly successful. This has ‘shrunk’ the global malaria map, meaning that at least for the time being, risk to travellers has diminished and is now concentrated in fewer geographical areas.
  • More than 90% of imported malaria cases in Australia are now acquired in Africa, Papua New Guinea, India or Indonesia. Risk has been eliminated or is close to being eliminated in many popular tourist destinations such as Sri Lanka, Vanuatu, Thailand, China, Malaysia, the Philippines, Nepal and Vietnam.
  • An increasing proportion of imported malaria is now seen in recent migrants, either on arrival to Australia or following travel back to their home country.
  • New treatments based on the artemisinin derivative class of drugs are much safer, better tolerated and more effective; artemether-lumefantrine can almost always be used as initial treatment.
  • Drug choices for prophylaxis remain doxycycline, atovaquone-proguanil and mefloquine, but all have risks and costs.
  • Mosquito avoidance measures will become more important, as they protect not only against malaria but other emergent viruses such as dengue, zika and chikungunya.

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© NECHAEVKON/SHUTTErSTOCK.COM
© NECHAEVKON/SHUTTErSTOCK.COM