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Travel Diseases

Malaria Prophylaxis

What is Malaria?

Did you know that malaria is the 5th cause of death from infectious diseases worldwide? (CDC)  It is caused by a parasite called Plasmodium. This parasite is commonly found in infected Anopheles mosquitoes which feed on humans, transmitting the parasite from one person to another person. Malaria is common in the tropics and south of the Saharan desert in Africa. The risk of getting infected by malaria is subject to the area of the country of travel and the activities the traveller is involved in.

What can I do to prevent malaria?

Malaria is prevalent in certain parts of the world and it can be prevented by the use of prophylactic medication as well as personal protection measures.

General protection measures are essential for the prevention of malaria and other mosquito-borne diseases. Malaria transmission occurs commonly between dusk and dawn as the Anopheles mosquitoes have nocturnal habits of feeding. Therefore, it is essential to take protective measures, especially during these periods.

Some examples of protective measures include:

  • Wearing long sleeved shirts and trousers to cover the body
  • Using insect repellents of >30% DEET on exposed skin
  • Bringing mosquito coils or hanging mosquito nets over bed during sleep
  • Spraying insecticide where the mosquitoes may rest, such as clear slow flowing streams

What prophylactic medications are available for malaria?

The choice of prophylactic medication for malaria is dependent on the country of travel. The risk of malaria and the resistance to anti-malarial medication may vary across a country as well. Do consult a pharmacist to find out if prophylaxis is required. During the consultation, remember to inform the pharmacist on all the places you would be travelling to, such as the province, state or district. Do remember that medical prophylaxis does not offer complete protection and general protective measures are still important.

Options of malaria prophylaxis:

  • Mefloquine
  • Doxycycline
  • Atovaquone/Proguanil

These medications need to be taken before the start of trip to the endemic area to allow the medication to reach effective levels in the body. After the trip, these medications also need to be completed till the recommended duration to act on any remaining parasites.

How do I know if I have malaria?

The symptoms of malaria include high fever, muscle ache, chills with uncontrollable shivering and profuse sweating. In some cases, jaundice, mental confusion or coma might occur.

I’m on malaria prophylaxis, will I still get malaria? What should I do if I get the above symptoms?

Malaria infection can still occur even if all recommended precautions against malaria have been taken. The symptoms can occur as early as 7 days after exposure or as late as several months after departure from a malaria prone area. Therefore, it is important that if the above symptoms are spotted within 1 year of return from the trip, the doctor should be informed of your possible exposure to malaria.

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