Delayed Onset of Malaria — Implications for Chemoprophylaxis

Abstract

Schwartz et al. (Oct. 16 issue)¹ report that a substantial proportion of cases of malaria in returned travelers are characterized by a late onset. The authors conclude that the usual chemoprophylactic agents do not prevent such cases and suggest switching to agents such as primaquine or atovaquone–chloroguanide for prophylaxis. However, we believe that other considerations — including tolerability and cost for the millions of travelers who remain malaria-free — are just as important.