Preparing your patients to travel abroad safely Part 3: Reducing the risk of malaria and dengue fever

OBJECTIVE To provide evidence-based recommendations for family physicians a dvising travelers on how to reduce their risk of malaria and dengue fever. OUALITY OF EVIDENCE A search of MEDLINE from 1990 to November 1998 found 67 1 articles; randomized controlled trials and systematic reviews were sought . The Cochrane Collaboration was searched for studies relevant to family ph ysicians; meta-analyses of impregnating bed nets with permethrin were found . Health Canada's evidence-based publications were searched; 10 recommendat ions based on at least one well-conducted randomized trial were found. MAIN MESSAGE Good evidence-based advice about the efficacy of mefloquine in chloroquine-resistant areas and for pregnant women and children is availab le, as is advice on the effectiveness of permethrin-impregnated bed nets. CONCLUSIONS Family physicians can use evidence-based recommendations to adv ise their patients on how to prevent malaria. The ways in which patients ne glect malaria precautions are well-known. For prevention of both malaria an d dengue fever, family physicians should counsel their patients to reduce t he risk of being bitten by insects.