Standby Emergency Treatment of Malaria in Travelers

Experience to Date and New Developments

Patricia Schlagenhauf; Eskild Petersen

Disclosures

Expert Rev Anti Infect Ther. 2012;10(5):537-546. 

In This Article

Definition & Rationale

SBET is described as the self-administration of antimalarial drugs when malaria is suspected and prompt medical attention is unavailable within 24 h of the onset of symptoms. It is indicated only in emergency situations[103] as a life-saving measure. The WHO publication International Travel and Health[103] provides a rational basis for this approach with the following statements:

"It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between 7 days after the first possible exposure to malaria and 3 months (or, rarely, later) after the last possible exposure. Any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment, and inform medical personnel of the possible exposure to malaria infection. Falciparum malaria may be fatal if treatment is delayed beyond 24 h after the onset of clinical symptoms."

and

"In light of the spread of counterfeit drugs in some resource-poor settings, travelers may prefer to buy a reliable supply of a reserve antimalarial treatment before departure, so that they can be confident of drug quality should they become ill. Many travelers will be able to obtain qualified medical attention within 24 h of the onset of fever. For others, however, this may be impossible, particularly if they will be staying in remote locations. In such cases, mosquito bite prevention can be combined with the carriage of antimalarial drugs for self-administration ('standby emergency treatment')."

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