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For Better and for Worse: How Our Dietary Habits Have Changed

Posted Friday 29 March 2019 14:12 by in Weight loss by Marina Abdalla

The health of UK adults is constantly shifting – with both positive and negative effects. For example, in 2016/17 there were 617,000 admissions to NHS hospitals in which obesity was a factor, a rise of 18% on 2015/16.[1] This is an important fact to note, as obesity is associated with a range of serious health concerns including several forms of cancer.[2]

However, in other ways our health is becoming more positive overall. For example, the UK has seen a huge reduction in deaths from infectious disease. In 1901, around a third of deaths were due to infectious disease, but now this is around 8%.[3]

Now, newly released results from a nine-year analysis of the UK National Diet and Nutrition Survey has provided a clear holistic picture of our nation’s health, for better and worse. Let’s take a look.

THE GOOD: We’ve seen a large drop in fizzy drink consumption

The findings report that a significant number of children are turning their backs on fizzy drinks, with numbers falling by a third in the last nine years. Around half of children do not drink them, and those that that do are consuming less than children did a decade ago in 2008-2009.[4]

This has helped to contribute to a larger overall reduction in sugar consumption across the country.

Researchers asked people to keep a diary over four days, and those who did not drink any fizzy drinks in that time were categorised as ‘non-consumers’. These accounted for over half of all respondents.

What’s more, these tests were carried out before the tax on sugary drinks was introduced in 2018.

THE BAD: More needs to be done to help increase fruit and vegetable intake

It wasn’t all good news. The report, from the Food Standards Agency and Public Health England, also found that fruit and vegetable consumption has not improved, and remains under the recommended five-a-day. Fibre intake has also fallen, as had vitamin and mineral consumption overall.[5]

The government campaign for five-a-day was launched in 2003, but seems to have had little effect. The campaign was based on advice from the World Health Organisation that eating a minimum of 400 grams of fruit and vegetables a day can lower the risk of serious health concerns like stroke, heart disease and various forms of cancer.[6]

The importance of lifestyle changes

What these results show is that improving your health begins by making the right lifestyle changes, be that increasing your fruit and veg intake or cutting down on high-sugar products.

Other examples of positive lifestyle changes would be engaging in regular exercise, which can help with weight management, mental health and cardiovascular health[7], or quitting smoking. Smoking is the single biggest avoidable risk factor for cancer, and it also plays a role in a whole host of other health concerns such as respiratory disease, diabetes and reproductive issues.[8]

Of course, medical intervention is often required for a wide range of physical and mental health concerns, be it in the form of surgery, counsel or medication. However, changing your lifestyle in positive ways is the ideal starting point for improving your health in the long run.

At Express Pharmacy, you’ll find medication for a range of health concerns, such as weight management, erectile dysfunction and smoking cessation. Our simple 3-step services makes it easy to access treatment quickly and discreetly. Get in touch to find out more. Call 0208 123 07 03 or use our Live Chat service.


[1] NHS Digital. Statistics on Obesity, Physical Activity and Diet. 2018 [Accessed March 2019]

[2] Cancer Research UK. Overweight and obesity statistics. 2018 [Accessed March 2019]

[3] Public Health Matters. 10 facts that sum up our nation’s health in 2017. 2017, Public Health England [Accessed Mach 2019]

[4] Public Health England. UK National Diet and Nutrition Survey. 2018 [Accessed March 2019]

[5] Public Health England. UK National Diet and Nutrition Survey. 2018 [Accessed March 2019]

[6] NHS UK. Why 5 a day? 2018 [Accessed March 2019]

[7] Bupa. Benefits of exercise. 2019 [Accessed March 2019]

[8] Action on Smoking and Health. Fact Sheets. 2018 [Accessed March 2019]

Tags: General Health Weight Loss

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Is Malaria Really That Serious?

Posted Thursday 28 March 2019 17:41 by in Anti Malaria by Johanna Galyen

It’s been around for centuries. We all know we should avoid it, protect ourselves from it, use the right medications to prevent it, and a net to protect our beds at night from it – but why? Why is malaria such a big deal? It’s 2019, should you really worry about a tiny mosquito as you travel on holiday this summer? Why is such a tiny little pest causing so many problems?

The answer is rather scary. The World Health Organisation stated “There were an estimated 219 million cases of malaria in 90 countries. Malaria deaths reached 435,000 in 2017.” While many measures are in place to help lower these terrible statistics, the prevalence of malaria is something that should not be ignored.

You need to know the symptoms of malaria

After being bitten by a mosquito carrying malaria, there are no symptoms initially. Only the female Anopheles mosquitos carry malaria, and they’re actually carrying a parasite that is injected into your bloodstream when they bite. These little ladies do not leave a bite mark, and the site does not swell up or does spot itch as most people think of mosquito bites. This is one of the reasons that the bite is so dangerous; you probably don’t even know that it happened.

The symptoms can take one to two weeks to appear (or even a year) in your body because the parasite travels to your liver and begins to grow there. The National Health Service (NHS) says that Malaria’s symptoms are similar initially to a flu-like illness:

  • High fever, above 38° C
  • Chills and sweats alternating
  • Headaches
  • Muscle aches
  • Vomiting
  • Diarrhoea

Without proper care, malaria can cause liver failure, fluid in the lungs (pulmonary oedema), kidney failure, anaemia, and ultimately death.

You Need to Know Where Malaria is Prevalent

Malaria countries, or countries affected by Malaria, are located in Africa, Central and South America, some parts of the Caribbean, Asia, Eastern Europe, and the South Pacific. Mosquitos like warm, moist climates and thrive in areas near bodies of water.

Africa has the most significant amount of malaria, according to WHO, and “it was found that 92% of malaria cases and 93% of malaria deaths was prevalent here” in 2017. The World Health Organisation also stated that “In 2017, five countries accounted for nearly half of all malaria cases worldwide: Nigeria (25%), the Democratic Republic of the Congo (11%), Mozambique (5%), India (4%) and Uganda (4%).”

You Need to Know How to Protect Yourself

If you are travelling to an area that has Malaria, there are many necessary steps to protect yourself from this disease. Each of the three preventative steps is important, but none of them will protect 100%. Therefore, if possible, you should utilise all three ways simultaneously.

1.Anti-Malarial Medications

Anti-Malarial medications work to destroy the parasite within the body. Three of these medications are Doxycycline, Malarone or Lariam. Because Malaria is a parasite that has different growing stages, these medications must be taken prior, during, and after your trip (for a certain number of weeks) to ensure that your body has the right amount of malaria-fighting properties in it. If you do not take the medication in its entirety, some of the parasites may survive.

While the three medications are equal in their effectiveness, they each come with differing side effects and interactions. It is essential that you speak with your GP to ensure that you take the right medication for you.

2. Malaria Net for Your Bed

A simple mosquito net for your bed is very inexpensive. It is so financially cheap that you may wonder why a net is so important? To help you understand this, it is good to remember that the female Anopheles mosquito doesn’t start working at 8 am. She likes to work late at night around 10 pm to 2 am, which most people are going to bed or asleep at these times. To prevent even one mosquito from biting you, a simple net can help protect you.

3. Bug Spray

So if you’re taking the medications and using a net, is bug spray still needed? The answer is yes. Bug spray is helpful if you are going to be up and moving during the later hours of the evening, such as walking outside of your tent to use the restroom. According to Fit for Travel, it is best to use a bug spray that has at least DEET 20-30%, Picaridin 20%, or Lemon eucalyptus 30%. They each smell differently, have varying concentrations and warnings and should be reapplied at different intervals. It is important to look carefully at your bug spray's directions and follow it’s recommendations.

You Need to Know What To Do If You Think You Have Malaria

Just like most illnesses, the sooner you can begin treatment for Malaria, the better it is for your body. So if you start experiencing symptoms, it is best to get to your healthcare provider and be tested. It is crucial to inform your doctor that you have been in an area that has Malaria so they can order the right blood tests that may be missed otherwise.

A thick blood smear is currently the most sensitive test accord to Lab Test Online, and it is considered to be “the gold standard” of testing. By taking a few large drops of blood, smearing it on a glass slide, and looking at it under a microscope, the doctor can search for the Plasmodium parasite.

If you do have Malaria, your GP may prescribe medication for you. Currently, Artemisinin-based combination therapies (ACTs) are used to treat Malaria. In years past, Chloroquine was used, but many types of Malaria have become resistant against them. Some physicians may use anti-malarial drugs in combination with ACT therapy as well. Whichever medications you are prescribed, it is important to take the entire dose of medicine in the right quantity each day. Even if you start to feel better after a few days, you must take all of the medication to ensure that all of the parasites are destroyed.

Conclusion

Malaria is a serious illness that you should take the appropriate preventative steps to avoid. Even though it has been around for centuries, it is still a significant threat to your health in 2019. So as you plan for your holiday this season, be sure to research and make the right plans for your trip. A little bit of planning and preventative steps can ensure that you will be healthy and able to enjoy your time away!

Being prepared for Malaria is very important, and we are here to help you get ready in the most effective way possible. Discover medications for your anti-malarial needs – here at Express Pharmacy. We can help you gain access to effective treatment swiftly and discreetly. Contact us today by calling 0208 123 07 03 or by using our online Live Chat service.

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How to Spot the Differences Between Hay Fever and a Cold

Posted Monday 18 March 2019 13:31 by in Hay Fever and Allergy Relief by Johanna Galyen

hay fever medication

As the cold weather turns into springtime, we start to feel the urge to get outside and enjoy the flowers, budding trees, gentle breezes, and sunshine. The excitement of the warmer weather can quickly dampen with the coming of hay fever season. But is it really hay fever? Is the scratchy sore throat a sign of allergies or an infection? Isn’t it still cold and flu season? Should I just stay home from work? Before the panic starts to ensue, let’s stop for a few moments and look at the eight differences between hay fever and the common cold.

1: The common cold is caused by a viral infection

According to Medical News Today, the common cold is most frequently from coronaviruses or rhinoviruses. While there are over 200 subtypes of viruses that can cause these symptoms, it is usually impossible to tell which virus is making a person sick. Thankfully, these viruses are generally short-lived, and you’ll start to feel better pretty soon.

2. Hay Fever is caused by an allergic reaction

pollen countThe body protects itself through the immune system. The immune system works 24:7 to protect you from germs, viruses, and bacteria. For those susceptible to hay fever, the pollen is identified as an invader and many symptoms like allergic rhinitis can be seen. Just know this: your immune system wants it gone!

To get rid of the allergen, the body produces histamine. Histamine is similar to a chemical messenger in that it signals your body to start making more fluids and mucus to trap the invader and flush it away. What does that mean for you? Hay fever can produce watery eyes, fluid in your ears, congestion in your nose, and a draining-like sensation in the back of your throat.

As annoying as these symptoms are, the body is just trying to protect itself from the foreign invaders. To treat these symptoms, your GP may recommend some antihistamines (a medicine that fights against the histamine).

3. An itchy throat is different than a sore throat

When you first notice that dreaded feeling in your throat, stop and evaluate what you are really feeling. There is a difference between a dry, scratchy (itchy) throat and a painful throat. Pain and soreness usually indicate an infection like the common cold. Severe throat pain may mean that you have a bacterial infection like strep throat.

A scratchy, itchy feeling in your throat is typical of allergies. This feeling is caused by the presence of pollen or growing grasses that irritates your nose and mouth.

A word of caution: An itchy throat is also a sign of a dangerous allergic reaction, called anaphylaxis. It may be accompanied by a swelling or a tight closing sensation in the back of your throat. Sometimes, a person’s voice may start sounding – typically higher-pitched and more strained. If you have any of these symptoms, seek medical treatment immediately by calling 999.

4. Check the colour of your mucus

This may sound a little bit gross, but the colour of your mucus is helpful to determine if you have allergies or illness. Clear drainage is typical of allergies whereas shades of yellow and green can indicate an infection. If you are seeing green, then you should be seeing your general practitioner.

Here’s a tip: don’t check the colour of the mucus for the first few hours when you wake up. During the night, the mucus can dry out somewhat, and it naturally turns yellow, greenish, and brown. Wait a few hours, and then see what colour it is.

5. Look at your eyes

The Eyes are the window to your soul – Shakespeare

Shakespeare wasn’t a physician, but he was very accurate when talking about the eyes. How your eyes look also can reflect your health. Symptoms of hay fever that involves the eyes can include:

  • Redness around the eyes
  • Itching of the eyes
  • Clear watering or tearing of the eyes
  • Puffiness around the eye
  • Pain around the sinuses

Sometimes a cold virus can affect the eyes, so it is important to highlight how the similarities and differences. Those who have a cold virus may experience:

  • Redness of the eye (also known as pink-eye)
  • Soreness around the eyes
  • Yellow or green drainage (worse in the mornings)
  • Painful eyes
  • Sinus pressure and pain

Remember, if you have yellow or green drainage coming out of your eyes, this should be handled carefully. The drainage can carry the virus and can be shared with others, so wash your hands frequently!

6. Timing is important

The timing, or the progression of a cold virus, is different than allergies. A cold often comes on slowly over a few days and progressively gets worse. Allergies can attack you at any time with any range of severity. How long that you are ill is also important to note. The common cold typically lasts up to 14 days. Allergies can last for weeks and months.

Here’s a tip: check the pollen counts for the day, and see if you should protect your nose and mouth from the pollen before you go outside.

7. Do you have body aches and a fever?

Aching joints and muscle pains are often the symptoms of the common cold or flu virus. These typically occur at the beginning of the infection. Additionally, if your body temperature goes above 37.6° C, this usually indicates that you have a fever as your body is trying to kill the virus.

Seasonal allergies, like hay fever, do not cause body aches or fever in most people. Some people may experience a slight increase in temperature, but it is really a fever unless your temperature passes 37.6° C or 100.4° F.

8. Is there an Allergic Salute?

Just as a member of the military salutes a higher-ranking official, there is a salute for allergies. The so-called allergic salute refers to the constant wiping of one’s nose. It can create a small red crease on the bridge of the nose, and it is most often seen in children. Adults, who suffer from hay fever, can also have this redness.

Those with the common cold typically have red, puffy noses from constant blowing, but they do not have the crease on their nose or are seen wiping it continually.

Knowing the difference between hay fever and the common cold is important for your health. In some situations, you may need additional support, treatment, and medication. Discover medication for a variety of health concerns – from antihistamines to nasal sprays – here at Express Pharmacy. We can help you gain access to effective treatment for hay fever swiftly and discreetly. Contact us today by calling 0208 123 07 03 or by using our online Live Chat service.

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Your Blood Type Could Increase Your Chances of Developing Travellers’ Diarrhoea, According to New Data

Posted Friday 15 March 2019 22:45 by in Travellers Diarrhoea by Tim Deakin

food market

Travellers’ diarrhoea, caused by viruses, bacteria or protozoa, is the most common infection experienced by travellers, affect over 20 percent of those who travel to high-risk destinations of the world.[1]

These high-risk areas are mostly found in South and South East Asia.[2] The condition occurs equally in male and female travellers and is more common in young adult travellers than in older ones.[3]

But now it seems that there many be other factors involved in one’s inclination towards or susceptibility to traveller’s diarrhoea – namely, blood type.

A new study[4], published in The Journal of Clinical Investigation, has found that those with Type A blood are likely to be struck down with travellers’ diarrhoea sooner and more severely. These findings are significant for UK travellers, as nearly half of Brits have type A or AB blood.[5]

Researches gave more than 100 volunteers water containing enterotoxigenic E.coli. The results found that 81% of those with type A blood required medical attention for diarrhoea as a consequence, compared to just 56% in other blood types.

The study concluded that this is due to the way E.coli releases a protein which latches onto the intestinal cells of those with blood type A.

How to avoid travellers’ diarrhoea

Travellers’ diarrhoea is defined as the passing of three or more loose/watery bowel motions within a 24-hour period. It can be accompanied by other symptoms such as stomach cramps, nausea, vomiting and fever.[6] Risk factors involved in travellers’ diarrhoea can include choice of eating place, season of travel, destination, diet, age and genetics.[7]

But despite being a common condition faced by many jet-setters, there are things you can do to significantly reduce your chances of contracting the disease.

The World Health Organisation has outlined their 5 key tips to enjoying safer food abroad, in an attempt to prevent the spread of food-borne diseases. These tips are:

  • Keep clean – wash your hands often, especially before handling food
  • Separate raw and cooked food – make sure cooked food is not contaminated with raw food
  • Cook food thoroughly – make sure food has been entirely cook and remains steaming hot
  • Keep food at safe temperatures – avoid food which has been left out such as at markets, buffers and street vendors
  • Choose safe food and water – Only drink sealed bottled water, or bring water to boil first. Peel all fruits and vegetables before consumption.[8]

The right medication can also offer a vital precautionary measure for travellers. Having access to effective travellers’ diarrhoea medication means that, should you fall victim to the infection, you are able to deal with your symptoms swiftly. Traveller’s diarrhoea treatment such as Ciprofloxacin and Azithromycin are available from Express Pharmacy.

Planning your next trip? Find effective medication at Express Pharmacy to ensure you stay safe. Get in touch today by calling 0208 123 07 03 or by using our discreet Live Chat service.


[1] Travel Health Pro. Travellers’ Diarrhoea Fact Sheet. 2019 [Accessed March 2019]

[2] British Medical Journal. Travellers’ diarrhoea clinical review. 2016 [Accessed March 2019]

[3] Connor, B.A. Traveller’s Diarrhoea.Centers for Disease Control and Prevention. 2017 [Accessed March 2019]

[4] Kumar, P. et al. Enterotoxigenic Escherichia coli-blood group A interactions intensify diarrheal severity. Journal of Clinical Investigation. 2018 [Accessed March 2019]

[5] NHS Blood and Transplant. Blood Types. 2018 [Accessed March 2019]

[6] NHS Fit For Travel. Travellers’ Diarrhoea. 2019 [Accessed March 2019]

[7] Hill, D.R., Beeching, N.J. Travellers’ Diarrhoea. Cur Opin Infect Dis. 2010 [Accessed March 2019]

[8] World Health Organisation. A Guide on Safe Food for Travellers. 2010 [Accessed March 2019]

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Checking in on Malaria Risk Levels Around the World

Posted Friday 08 March 2019 12:03 by in Express Pharmacy by Tim Deakin

malaria protection

As one of the most dangerous and widespread diseases in the world, malaria is a condition that is constantly evolving. By looking at how the condition has changed and spread throughout the world, we can gain a clearer understanding of how to avoid it effectively when travelling.

Every traveller should be aware of the potential risks posed by infectious conditions such as malaria. Put simply, malaria is a serious tropical disease, spread by mosquitos. It can be fatal if left untreated, and a single mosquito bite is all it takes for someone to become infected with malaria.[1]

Despite still being a significant travel health risk today, the origins of malaria date back millions and millions of years. In fact, fossil mosquitoes have been found in geological strata 30 million years old.[2] What’s more, a variety of studies have suggested that P.falciparum malaria probably jumped from great apes to man, most likely by a single host transfer by vector mosquitos.[3] Findings indicate that malaria traces back to gorillas.[4]

As well as having a long and complex history behind it, the condition also has a huge geographical spread. Let’s take a closer look at malaria risk levels across time periods and around the world.

A timeline of malaria

We’ve already mentioned that, as well as being a dangerous and widespread condition, malaria is also an ancient one. In truth, the origins of malaria dates back hundreds of millions of years, yet it remains a significant health risk in several parts of the world today. Below is a timeline of how malaria has transformed over millennia.

Half a billion years ago: Existence of a pre-parasitic ancestor of the vector mosquito

150 million – 200 million years ago: Appearance of early Dipterans, ancestors of mosquitoes

130 million years ago: Evolution of two-host life cycle in Dipterans and vertebrates

130 million years ago: Divergence of the bird and mammalian malaria parasites

100 million years ago: Divergence of P.malariae, P.ovale and P.vivax lineage

5 million years ago: Evolution of P.falciparum

2-3 million years ago: Divergence of P.vivax from P.cynomolgi

10,000 years ago: Malaria appears in Africa

10,000 – 5,000 years ago: Malaria appears in Mesopotamia, the Indian peninsula and South-East Asia

4000 – 10,000 years ago: Appearance of the lethal strain of P.falciparum

5000 years ago: Malaria appears in China

4000 – 5000 years ago: In Africa, Anophelines develop highly anthropophilic habits

3000 years ago: The lethal P.falciparum strain of malaria reaches India

2500 – 2000 years ago: Malaria reaches the shores of the Mediterranean

1000 – 500 years ago: Malaria reaches Northern Europe

Late 15th Century: Malaria reaches the New World and much of the western hemisphere

Mid-18th Century: Malaria spreads across North America

19th Century: Malaria is now present across the globe

Early 20th Century: Millions of people die from malaria all over the world

Early 1950s: Malaria has almost disappeared from North America and from almost all of Europe

Present: Malaria fatalities almost entirely limited to sub-Saharan Africa.

Malaria worldwide

anti malarialThe World Health Organisation (WHO) estimates that 219 million cases of malaria occurred across the globe in 2017. Of these cases, around 435,000 people died from the disease. This number mostly consisted of children under 5 years of age in sub-Saharan Africa.[5]

International travellers could find themselves at risk of malaria infection in 87 countries around the world, most notably in Africa, Asia and the Americas. Those who do become infected with malaria often experience initial flu-like symptoms, as well as fever and chills. If left untreated, these symptoms can escalate into severe complications and even fatality.

Symptoms of malaria usually appear after a period of seven days or longer, though it can be sooner.

Malaria is caused by the Plasmodium parasite, transmitted by female Anopheles mosquitos which bite between dusk and dawn. Five strands of the Plasmodium virus regularly infect humans. These are falciparum, vivax, ovale, malariae and knowlesi.[6] While P.falciparum is the most dangerous strand, P.vivax is now the most geographically widespread of the human malarias, as it is estimated to account for 100-300 million clinical cases of the infection across Asia, Central and South America, and the Middle East.[7]

The deadly P.falciparum strand of malaria is considered a serious public health concern in most countries within sub-Saharan Africa.

Preventing malaria

In many instances, malaria can be prevented. An easy way to remember the precautions you should take is by thinking of them as the ABCD approach.[8] This consists of:

Awareness of risk: find out whether your destination carries a risk of malaria before you travel

Bite prevention: avoid mosquito bites by using things such as insect repellent and an insecticide-treated mosquito net. You should also cover your arms and legs whenever possible

Check whether you need anti-malarial medication: Explore the various treatment options available. Always ensure you use the right dose and finish your course of medication

Diagnosis: Seek immediate medical advice if you develop any malaria symptoms for as long as up to a year after you return from your travels abroad.

Always speak to your GP if you’re planning to visit an area where there is a malaria risk.

Malaria risk countries

One of the most important questions to ask yourself when travelling is whether malaria is a risk factor in your destination. Being aware of potential malaria risks before you travel is essential, as the most serious forms of malaria can become life-threatening after just 24 hours.[9]

Most malaria cases in 2017 were within the WHO African Region (92%, or around 200 million). This is followed by the WHO South-East Asia Region (5% of cases) and the WHO Eastern Mediterranean Region (2%).[10]

Almost 80% of global malaria cases occurred within just 15 countries in sub-Saharan Africa and India, and five countries accounted for almost half of all malaria instances worldwide: Nigeria (25%), Democratic Republic of the Congo (11%), Mozambique (5%), India (4%) and Uganda (4%).[11]

If you’re planning to travel further than Europe, you should carefully research any potential malaria risks in your area.

Understanding malaria is key to avoiding the condition when travelling further afield. If you’re worried that you may be at risk of the condition while travelling, contact Express Pharmacy today. We can provide effective anti-malarial medication such as Malarone and Doxycycline. Speak to one of our pharmacists today by calling 0208 23 07 03 or by using our discreet online Live Chat service.


[1] NHS UK. Malaria Overview. 2018 [Accessed March 2019]

[2] Carter, R., Mendis, K.N. Evolutionary and Historical Aspects of the Burden of Malaria. Clinical Microbiology Reviews. October 2002; 15(4) [Accessed March 2019]

[3] Alcock, K. Cerebral malaria may have passed from gorillas to us. 2010 [Accessed March 2010]

[4] Liu, W. et al. Origins of the human malaria parasite Plasmodium falciparum in gorillas. Nature. September 2010 [Accessed March 2019]

[5] World Health Organisation. Malaria, Information for Travellers. 2019 [Accessed March 2019]

[6] Public Health England. Advisory Committee for Malaria Prevention. Guidelines for malaria prevention in travellers from the UK. 2018 [Accessed March 2019]

[7] Rich, S.M., Ayala, F.J. Evolutionary Origins of Human Malaria Parasites. Springer US. 2006 [Accessed March 2019]

[8] NHS UK. Malaria. 2018 [Accessed March 2019]

[9] NHS Fit For Travel. Malaria. 2019 [Accessed March 2019]

[10] Travel Health Pro. Malaria Factsheet. 2019 [Accessed March 2019]

[11] World Health Organisation. World Malaria Report 2018 [Accessed March 2019]

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