Standby emergency treatment of malaria for travellers to low transmission destinations. Does it make sense or save lives?

An update on prevention of malaria in travelers

“…SBET alone can be considered if traveling to low malaria transmission areas such as most of southeast Asia and South America. If possible, SBET should only be considered when traveling to remote areas where medical attention is hampered by a lack of medical services, or quality medications and access to a medical evaluation is not readily available within 24 h. 65 It is important to emphasize to the traveler that the development of fever requires immediate evaluation regardless of SBET use.…”

“…The topic is controversial and the appropriate setting for its use varies according to different national guidelines. 65 There is great variation in the proportion of travelers that appropriately use this strategy as response to the development of fever which is of primordial importance given the life-threatening nature of the disease. 66 For travelers taking chemoprophylaxis and for whom SBET is prescribed, the drug that is being used for chemoprophylaxis should not be used for treatment.…”

Malaria standby emergency treatment (SBET) for travellers visiting malaria endemic areas: a systematic review and meta-analysis

“…The importance of proper preventive measures against malaria is emphasized by a case fatality rate of malaria among international travelers to be around 1% (2,3). While chemoprophylaxis remains the standard preventive measure for international travel to countries at high-risk of malaria transmission, preventive measures for travelers to low or moderate-risk areas, most notably the use of standby emergency treatment (SBET), remains controversial (4)(5)(6).…”

“…Opponents of SBET propose daily chemoprophylaxis for low or moderate malaria endemic areas because of the potential fast progression to severe disease even when treated promptly, and question as well travelers' capabilities to respond appropriately to the SBET recommendations. Others argue that mosquito protection is sufficient for such areas given the easy access to health facilities in touristic areas, the risk of neglecting other lethal diseases when using SBET, and the wasted resources of unused anti-malarial drugs (4,14).…”

Notfallmäßige Selbstbehandlung für Reisende in Malariagebiete mit geringem Transmissionsrisiko

“…So kann das Mitführen einer SBET für Langzeitreisende oder Reisende in abgelegene ländliche Regionen durchaus geeignet sein. Bei Kurzurlauben in touristisch gut erschlossene Gebiete in Süd-und Südostasien sowie Südamerika mit geringer Malariatransmission ist sie bei Einhaltung von Maßnahmen der Expositionsprophylaxe in der Regel entbehrlich und wird auch von weiteren Experten kritisch hinterfragt[15].…”