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<p>In June 2017, the Government updated its policy on Preventing Malaria in UK Armed
Forces Personnel (Joint Service Publication 950, Part 1, Leaflet 3-3-1). The leaflet
includes guidance on antimalarial drug use, requiring that drugs only be supplied
after a face-to-face malaria health risk assessment, following the Defence Medical
Information Capability Programme antimalarial protocol.</p><p>The recommended drug
regime is determined by the sensitivity of malaria parasites to antimalarial drugs
in different parts of the world, based on Public Health England guidance. For areas
without drug resistance the recommendation is that individuals are offered chloroquine
on its own. If chloroquine is not suitable then proguanil is the preferred alternative.
For areas of little chloroquine resistance, it is recommended that individuals are
offered both chloroquine and proguanil. If chloroquine and proguanil are not suitable
and the patient can tolerate proguanil then the patient should normally be offered
atovaquone and proguanil.</p><p>For areas where malarial parasites are known to be
resistant to chloroquine it is recommended that individuals are offered atovaquone
and proguanil. If atovaquone and proguanil is not suitable they are to be reviewed
in order to determine which alternative drug is most appropriate. The second choice
drug will normally be doxycycline but may be modified in accordance with the disease
profile of the country to be visited. If doxycycline is unsuitable then mefloquine
may be prescribed but only after the individual has been reviewed by a doctor.</p>
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