Treatment resistant malaria reported in the United Kingdom (UK) in a traveller who visited Uganda

UK Health Security Agency Advisory Committee on Malaria Prevention highlights the first case of Plasmodium falciparum artemisinin resistant malaria reported in the UK

In September 2022, the first case of Plasmodium falciparum artemisinin drug resistant malaria (carrying the variant pfk13_675V) was reported in a UK resident who travelled to Uganda, an important destination for UK travellers [1].

Artemisinin Combination Therapy (ACT) consists of two or more drugs with different types of action on the malaria parasite and is the recommended choice of treatment for P. falciparum malaria [2]. Following this case, the Malaria Reference Laboratory is monitoring closely for further evidence of ACT treatment failure [1].

This case highlights the importance of malaria prevention for travellers, including good compliance with antimalarial prophylactic drug regimens, as the current preventive measures are more than 90% effective when used correctly.

Advice for travellers

Check our Country Information pages 'Malaria' section for the individual malaria risk recommendations at your destination.

If visiting malaria risk countries, make sure you always use mosquito bite avoidance measures (see insect bite precautions) and have the appropriate antimalarial tablets for your destination. This is very important, even if you were born and brought up in a malaria risk country and are returning to visit friends and family.

Remember to finish your course of antimalarial tablets when you return to the UK.

If you develop any symptoms such as high fever, flu like symptoms and severe headache, you must seek urgent medical attention, tell your doctor/health professional that you visited a malaria risk area and obtain a same-day malaria blood test.

Advice for health professionals

Clinicians are reminded to be vigilant and consider malaria in all unwell travellers returning from a malaria risk country, especially those with a fever or flu-like symptoms [1].

Expert advice on malaria treatment should be sought from the local Infectious Disease Unit. Cases of suspected antimalarial treatment failure must be discussed urgently; expert advice is also available from the Hospital for Tropical Diseases and the Liverpool School of Tropical Medicine.

All malaria-positives, from all geographical areas, should be confirmed in the Malaria Reference Laboratory.