Malaria Prevention for Travellers: Tablets, Symptoms and Travel Advice

By MediLeave Editorial Team  |  Medically reviewed by Dr Sabrina Campbell (BSc, MBBS, MRCGP, FRACGP, MSc)  |  Last reviewed 20 October 2026

Planning a trip to a malaria-risk area? Flights and accommodation may be the first things on your list, but malaria prevention deserves a place there too.

Malaria can become serious quickly, particularly with Plasmodium falciparum, but the risk can be reduced with the right combination of mosquito protection and antimalarial medication when it is recommended for your itinerary.

The important thing to know is that malaria risk is not necessarily the same across an entire country. Your doctor may need to know the exact cities, provinces, rural or forest areas, season and length of stay before deciding whether malaria tablets are required.

Quick answer: If you are travelling to an area with malaria transmission, speak with a GP or travel health clinician before you leave. Some antimalarial tablets only need to be started 1 to 2 days before entering the risk area, so even last-minute travellers may still have options.

What is malaria?

Malaria is an infection caused by Plasmodium parasites. It is spread through the bite of an infected female Anopheles mosquito.

Several types of malaria can infect humans. P. falciparum is the type most likely to become severe quickly, while P. vivax and P. ovale can remain dormant in the liver and cause illness again later.

Australia is malaria-free, but Australians can still become infected while travelling overseas.

There is currently no malaria vaccine routinely available in Australia for traveller protection, so prevention relies on avoiding mosquito bites and taking antimalarial medication when it is recommended.

Malaria symptoms: what should you watch for?

Early malaria can look very similar to influenza, gastroenteritis or another viral illness.

Symptoms can include:

• fever, which may come and go
• chills, shivering and sweating
• headache
• muscle aches
• marked tiredness
• nausea
• vomiting
• diarrhoea

When is malaria an emergency?

Malaria, especially falciparum malaria, can deteriorate rapidly.

Severe illness may cause:

• confusion
• seizures
• breathing difficulties
• jaundice
• kidney problems
• severe anaemia
• shock
• loss of consciousness

If you develop a fever during travel or after returning from a malaria-risk area, seek medical care urgently and tell the clinician exactly where you have travelled.

Taking malaria tablets does not completely rule malaria out.

Suspected malaria requires prompt in-person assessment and blood testing and is not something that should be managed through telehealth alone.

How long after travel can malaria symptoms appear?

Symptoms often begin within a few weeks of infection, although timing varies depending on the type of malaria.

Falciparum malaria commonly presents within the first month after returning home, while P. vivax and some other species can present later.

If you become unwell after travelling, even weeks or months later, make sure you tell your doctor about your travel history.

Malaria testing may occasionally need to be repeated if the first result is negative but there is still a strong clinical suspicion of infection.

Where is malaria a risk?

Malaria occurs in parts of:

• Africa
• Asia
• the Pacific
• Central America
• South America

The highest risk is found in many parts of sub-Saharan Africa.

Malaria also occurs in Papua New Guinea, the Solomon Islands, parts of South and Southeast Asia, and some regions of Central and South America.

Importantly, risk can vary significantly within the same country.

A capital city or popular beach resort may have little or no malaria transmission, while nearby rural, border or forest areas may require malaria prevention medication.

This is why your exact itinerary matters more than simply naming the country you are visiting.

Do Australian travellers still get malaria?

Yes.

Australian surveillance data recorded more than 3,000 cases of malaria between 2012 and 2022.

Almost half were acquired in sub-Saharan Africa, and P. falciparum, the most serious type of malaria, accounted for the majority of cases.

Papua New Guinea was also an important source of malaria infections in Australian travellers.

People travelling to visit friends and relatives can sometimes be at higher risk because any partial immunity developed from previously living in a malaria-endemic country decreases after living away.

How to prevent malaria while travelling

Malaria prevention works best when mosquito protection is combined with antimalarial medication when appropriate.

1. Avoid mosquito bites

Use an insect repellent containing DEET or picaridin (icaridin) and reapply it according to the instructions.

If using sunscreen and insect repellent together, apply sunscreen first and insect repellent afterwards.

When practical:

• wear loose, light-coloured long sleeves and long trousers
• take extra precautions between dusk and dawn
• choose screened or air-conditioned accommodation
• use an insecticide-treated mosquito net if your room is not adequately screened

Mosquito protection also reduces your risk of other mosquito-borne infections such as dengue, Japanese encephalitis and chikungunya.

2. Take malaria tablets if they are recommended

No antimalarial medicine provides 100% protection, so mosquito precautions remain important.

The most appropriate medication depends on:

• where you are travelling
• how long you are staying
• your age
• pregnancy status
• kidney function
• medical history
• other medications
• how soon you are leaving

Two commonly prescribed options for Australian travellers are atovaquone/proguanil (Malarone) and doxycycline.

Malarone

Atovaquone/proguanil, commonly known as Malarone, is taken once daily.

It is usually started 1 to 2 days before entering the malaria-risk area, taken every day while you remain in the area, and continued for 7 days after leaving.

Malarone is often convenient for:

• shorter trips
• last-minute travel
• travellers who do not want to continue medication for several weeks after returning home

It is generally well tolerated but can occasionally cause nausea, abdominal discomfort or headache.

It is not suitable for everyone, including people with severe renal impairment, and is generally avoided during pregnancy unless specialist advice indicates otherwise.

It should preferably be taken with food or a milky drink.

Doxycycline

Doxycycline is also taken once daily.

It is generally started 1 to 2 days before entering the malaria-risk area, continued throughout the trip and then taken for 4 weeks after leaving.

Doxycycline can be a useful option for longer trips or where cost is an important consideration.

Possible side effects include:

• increased sensitivity to sunlight
• nausea
• reflux or irritation of the oesophagus
• vaginal thrush in some patients

Take doxycycline with a full glass of water and avoid lying down immediately afterwards.

It is not suitable during pregnancy and is generally not used for malaria prevention in children under 8 years of age.

Malarone or doxycycline: which is better?

There is no single malaria tablet that is best for everyone.

Malarone is often convenient for shorter trips because it only needs to be continued for 7 days after leaving a malaria area.

Doxycycline may be more suitable for longer travel or where cost matters, but it must be continued for 4 weeks after leaving and can make your skin more sensitive to sunlight.

The final decision should be based on your exact destination and medical history rather than price or convenience alone.

Are there other malaria tablets?

Yes.

Other options include medications such as mefloquine and tafenoquine.

Mefloquine may not be suitable for people with certain psychiatric conditions, seizure disorders or some cardiac conduction problems.

Tafenoquine is only suitable for adults and requires a blood test confirming normal G6PD activity before it can be prescribed.

Your doctor will determine whether these are suitable based on your individual circumstances.

What if I forget a dose?

Take the missed dose when you remember unless it is almost time for the next dose.

Do not take a double dose unless a doctor or pharmacist specifically advises you to.

Continue mosquito precautions carefully.

If you have missed several doses, speak with a doctor or pharmacist because your level of protection may have been reduced.

Can you still get malaria while taking malaria tablets?

Yes.

Correctly chosen and properly taken malaria prevention medication is highly effective, but no medication provides complete protection.

This is why any fever during or following travel to a malaria-risk area should still be medically assessed, even if you took every tablet exactly as prescribed.

How is malaria diagnosed?

Malaria is diagnosed with urgent blood testing.

Testing may include a malaria blood film and/or rapid diagnostic test.

Sometimes more than one blood test is required because a single negative result does not always completely exclude malaria when clinical suspicion remains high.

How is malaria treated?

Malaria is treatable, particularly when it is diagnosed early.

The treatment required depends on:

• the malaria species
• where the infection was acquired
• local drug resistance
• pregnancy status
• the severity of the illness

Severe malaria requires urgent hospital treatment.

Common malaria myths

“I grew up in a malaria country, so I’m immune.”

Any partial immunity developed while living in a malaria-endemic area can decrease after moving away.

People returning to visit friends and relatives can still develop malaria and may become seriously unwell.

“It’s only a short trip, so I don’t need malaria tablets.”

Even a short stay can involve malaria exposure.

Whether medication is recommended depends on the location and type of travel, not simply how many days you will be there.

“Malaria tablets mean I don’t need mosquito repellent.”

You need both.

No malaria medicine is completely protective, and mosquito repellent also helps protect against other illnesses such as dengue.

“Natural or homoeopathic products prevent malaria.”

There is no reliable evidence that natural or homoeopathic products prevent malaria.

Use recognised mosquito precautions and evidence-based antimalarial medication where recommended.

Getting malaria tablets online with MediLeave

Ideally, arrange travel health advice 4 to 6 weeks before departure.

This allows time to review your itinerary, routine vaccinations and any additional vaccinations recommended for your destination.

However, if you are leaving sooner, you may still have options.

Both Malarone and doxycycline can generally be started only 1 to 2 days before entering a malaria-risk area.

During a MediLeave travel health consultation, an Australian-registered doctor can review:

• your destinations
• your planned activities
• rural or forest exposure
• your medical history
• your regular medications
• pregnancy status where relevant
• how long you will be travelling

If malaria prevention medication is clinically appropriate, an eScript can be issued for a suitable antimalarial.

If vaccinations, blood testing or an in-person medical assessment are required, the doctor can advise you about the appropriate next step.

MediLeave can assist with pre-travel assessment and malaria prevention.

However, if you develop a fever or become significantly unwell during or after travel to a malaria-risk area, seek urgent in-person medical assessment rather than relying on a telehealth consultation.

Frequently asked questions

Do I need malaria tablets for Thailand, Bali or Cambodia?

It depends on the exact itinerary.

Many popular tourist areas have little or no malaria transmission, while some rural, border and forest regions carry a greater risk.

A travel consultation should consider the specific cities, provinces and activities included in your trip.

When should I start Malarone?

Malarone is generally started 1 to 2 days before entering a malaria-risk area, taken every day while you remain in the area, and continued for 7 days after leaving.

How long do I take doxycycline for malaria prevention?

Doxycycline is generally started 1 to 2 days before entering the malaria-risk area, taken daily throughout the period of exposure and continued for 4 weeks after leaving.

Can I get malaria even if I took prevention tablets?

Yes.

Malaria prophylaxis is highly effective but not perfect.

Any fever during or after travel to a malaria-risk area requires prompt medical assessment.

Can I get malaria tablets through telehealth in Australia?

Often, yes.

If a doctor can safely assess your itinerary, medical history and current medications and malaria prophylaxis is appropriate, an eScript may be issued.

Some circumstances may still require additional testing or an in-person medical assessment.

Before you travel

Check the malaria risk for every location on your itinerary, rather than simply looking at the country as a whole.

Make sure you have enough medication for the complete course, take an effective mosquito repellent and know what to do if you develop a fever.

References

1. Healthdirect Australia. Malaria. Last reviewed May 2026.
2. Centers for Disease Control and Prevention. CDC Yellow Book 2026: Malaria.
3. Centers for Disease Control and Prevention. Choosing a Drug to Prevent Malaria.
4. Centers for Disease Control and Prevention. Malaria Information and Prophylaxis by Country.
5. Sohail A, et al. Imported malaria into Australia: surveillance insights and opportunities. Journal of Travel Medicine. 2024;31(3):taad164.