OSCE Toolbox | Malaria Counselling 2 - Scenario

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Scenarios

By Femi Lana • May 26, 2026 • Last reviewed: 2025-12-28 •

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Summary Expert

In this scenario, the student is working as a community pharmacist and tasked with counselling a patient on malaria prevention before their holiday abroad. The student must provide appropriate advice and answer any questions.

Please ensure that this scenario and mark scheme align with the most up-to-date guidelines from the UK NICE and the BNF when using it for your OSCE assessment.

You will need a student pharmacist and an actor for this OSCE station.

Revision Topics

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Student Instructions

Actor Instructions

This may reveal scenario objectives!

Mark Scheme

Introduction

0 / 2

Introduces self as the pharmacist with an appropriate greeting

+1

Confirms patient details: Name, age

+1

History

0 / 7

Takes a brief travel history:

Travelling to malaria-risk country

+1

Duration of stay

+1

Type of accommodation (urban home)

+1

Outdoor evening exposure and mosquito risk

+1

Confirms medical history

+1

Hypertension and mild depression

Confirms medication history

+1

Amlodipine 5mg OD and Sertraline 50mg daily

Checks for any allergies and confirms the nature of reaction.

+1

Answer Q1: I’ve had malaria before, shouldn’t I be immune by now?

0 / 3

The student explains that you do not become reliably immune to malaria, even if you have had it multiple times in the past.

+1

Explains that any natural immunity gained while living in a malaria-endemic area fades after moving away, especially after living in the UK for many years.

+1

Explains that returning travellers are at similar risk to someone who has never had malaria and still require full chemoprophylaxis.

+1

Answer Q2: What are my options for malaria tablets?

0 / 5

The student effectively counsels the patient on the different options for chemoprophylaxis:

Doxycycline: Taken once daily; start 1–2 days before travel, continue for the duration of the stay, and for 4 weeks after leaving.

+1

Atovaquone/Proguanil (Malarone®): Taken once daily with food; start 1–2 days before travel, continue during the stay, and for 7 days after leaving.

+1

Mefloquine: Taken once weekly; must be started 2–3 weeks before travel; continued weekly during the stay and for 4 weeks after

+1

The student must state that mefloquine is contraindicated in this patient due to their history of depression and current use of sertraline.

+1

The student should explain to the patient that the most suitable option for them would be Atovaquone/Proguanil (Malarone®) as it is generally well tolerated and often preferred for shorter trips due to shorter post-travel course.

+1

Answer Q3: I would have preferred the once weekly tablet, do I actually need to take one every day once I’m back home?

0 / 1

Explains that Atovaquone/Proguanil (Malarone®) must be taken once daily and continued for 7 days after leaving the malaria area to ensure full protection from any parasites acquired late in the trip.

+1

Management

0 / 8

Establishes the patient’s malaria exposure risk (destination, rural stay, accommodation, duration, outdoor activities) and advises that prophylaxis is required .

+1

It’s important to conduct a full malaria travel-risk assessment to ensure you are not missing key factors that determine whether prophylaxis is required. country-specific travel advice can be found on NaTHNaC

Counsels the patient on how Atovaquone/Proguanil (Malarone®) is taken for malaria prophylaxis:

Take ONE adult tablet once daily with food or a milky drink.

+1

Start the tablets 1–2 days before travel, continue every day while in the malaria area, and continue for 7 days after leaving.

+1

Take the dose at the same time each day to ensure consistent protection.

+1

Advises that:

Malaria prophylaxis, including Atovaquone/Proguanil (Malarone®), is not available on the NHS

+1

The patient will need to obtain the medication privately through a community pharmacy offering private travel-health services, or a private travel clinic that can supply malaria prevention medicines.

+1

The student should explain that these services will involve a private consultation and a private prescription cost

+1

Advises the patient to seek urgent same-day medical assessment (A&E / urgent care / GP same-day) if symptoms develop during travel or after returning to the UK.

+1

Communication

0 / 6

Use appropriate language for the person and situation.

+1

Demonstrates empathy

+1

Ensure the patient understanding and signposts to further resources (e.g. NHS website or BNF)

+1

Signposts and refers patients to relevant resources e.g. NHS website

+1

Concludes the conversation well by asking if there are any further questions

+1

The student did not say anything that could harm the patient

+1

This includes but is not limited to, providing incorrect information or medication, misdiagnosing conditions, neglecting to inquire about allergies, making incorrect referrals, or failing to act on red-flag symptoms.

Time Management

0 / 1

Completed the scenario in time and achieved 70% of marks

+1