Paeds Cases · infectious-diseases
Explaining the fever-after-travel rule and prophylaxis adherence — OSCE
Communication OSCE on explaining to a visiting-friends-and-relatives family why malaria prophylaxis must be taken as prescribed and continued after return, why the child still needs bite avoidance despite the tablets, and what the fever-after-travel rule is — delivered in plain, non-alarmist language that holds the family's trust and converts advice into a plan they can act on.
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Candidate instructions (8-minute station)
You are the paediatric registrar in the general paediatric clinic. A four-year-old boy is seen six weeks before a one-month visit to grandparents in rural Bangladesh. The family is visiting friends and relatives. You have prescribed atovaquone-proguanil and given the hepatitis A and typhoid vaccines. [4]
Your tasks are: [3]
- Explain to the parents why the malaria tablets must be started before travel, taken every day while away, and continued for one week after return — and why stopping early is the commonest reason the tablets fail. [3]
- Explain why the child still needs insect-bite avoidance even though he is taking prophylaxis, and how dengue differs from malaria in this respect. [4]
- Give the fever-after-travel rule in plain language: what should bring the family straight to medical care after they return, and what they must tell the doctor. [3]
You are not expected to discuss antimalarial drug dosing in detail, to manage a febrile returned traveller, or to give a full pre-travel vaccine schedule. [4]
References4ShowHide
- [1]Freedman DO; Weld LH; Kozarsky PE; Fisk T; et al Spectrum of disease and relation to place of exposure among ill returned travelers N Engl J Med, 2006.PMID 16407507
- [2]Bacaner N; Stauffer B; Boulware DR; Walker PF; et al Travel medicine considerations for North American immigrants visiting friends and relatives JAMA, 2004.PMID 15199037
- [3]Kiang KM; Bryant PA; Shingadia D; Ladhani S; et al The treatment of imported malaria in children: an update Arch Dis Child Educ Pract Ed, 2013.PMID 23171589
- [4]Weinberg M, Hickey PW Traveling Safely with Infants and Children CDC Health Information for International Travel, 2025.PMID 41818599