Questionnaires on various aspects of
malaria prophylaxis were distributed to all British residents (adults and children) of Lilongwe and Kasungu districts, Malawi, and were completed and returned by 293 (response rate 89%). Almost all residents used some measures to reduce mosquito contact, and 96% used
chemoprophylaxis. Eight different chemoprophylactic regimens were used.
Proguanil, alone or with
chloroquine, was the most popular agent despite being associated with
mouth ulcers in 25% of residents. Residents on this regimen had in general obtained their advice from a British source, and 75% considered they were adequately informed on the subject. This regimen was the most effective in preventing
malaria attacks in the previous 12 months, even though over half those on
proguanil alone were taking an inadequate dose. Residents on other chemoprophylactic regimens in general obtained their advice elsewhere, considered they were inadequately informed, and had a higher incidence of
malaria. Whatever the regimen, 27% of adult residents would discontinue prophylaxis prematurely on return to the United Kingdom. Results suggest that more needs to be done to provide regular, precise and up-to-date information on
malaria prophylaxis to British residents in
malaria endemic areas.