Antimalarials and Malaria treatments for prevention

Malaria is an infection caused by the Plasmodium parasite. Malaria is normally passed on from person to person through the bite of an infected female anopheles mosquito. Malaria is a serious disease and across those areas directly affected one child dies every 30 seconds from it. In the UK about 1,750 holiday makers are infected with malaria whilst on their travels, and many infections are caused by people failing to take any preventative measures. If you plan to travel to a rick zone in Africa, Asia, Central or Latin America it is highly recommended you take anti-malaria tablets with you.

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Anti-malarial medicines

Medications to prevent malaria infection are widely available, and when used correctly are the most effective way of avoiding infection. Although no ant malarial treatment is 100% effective, taking anti-malaria tablets will go a long way in reducing your chances of getting what is potentially a fatal disease. The four types of treatment available are Malarone, Lariam, Doxycycline, Chloroquine and Paludrine. With the exception of Chloroquine (Avloclor or Nivaquine) and proguanil (Paludrine), which can be bought over the counter from your pharmacist, all malaria tablets must be prescribed by a doctor.

The type of anti-malaria tablet you take depends on which area you intend on travelling to and the period of time you are staying away. Your doctor will check your medical history and, for women, will ask if there is any chance of you being pregnant.

Prescription only malaria tablets:

Malarone (Proguanil with atovaquone)

Malarone is the newest anti-malaria tablet and is made up of a combination of medicines. Side effects include headaches, diarrhea and vomiting, however this tends to be well tolerated. Malarone has the easiest dosing regime lasting the shortest time:

For Malaria prevention take:

• Once daily for two days before you go
• Once each day you are there
• And once a day for one week after leaving the risk area

Lariam (Mefloquine)

Lariam is effective in areas where malaria is resistant to cholorquine, however it can cause undesirable side effects such as: anxiety, depression, sleep problems, dizziness, headache, stomach pains, diarrhea and tummy upset.

For Malaria prevention take:

• Once during the week before you go
• Once weekly, on the same day each week, whilst you are away
• Once weekly, on the same day each week, for four weeks after leaving the risk area

Doxycycline

Doxycycline is a wide spectrum antibiotic and is used to treat infection. As an anti-malarial it is highly effective though side effects include: diarrhea and thrush.

Other important points on antimalarials:

• Doxycycline can increase your skin’s sensitivity to the sun, so take extra sun protection precautions.
• Doxycycline can interfere with the pill, so take extra contraceptive precautions.

For Malaria prevention take:

• Once daily during the week before you go
• Once daily each day you are there
• And once daily four weeks after leaving the risk area

Over-the-counter pharmacy anti-malarials

Chloroquine and Proguanil

Check with your pharmacist before buying this medication as mosquitoes in some areas have become resistant to chloroquine after many years of exposure.

Take Chloroquine (weekly):

• On the same day each week
• Once during the week before you go
• Once a week whilst you are there
• And once a week for four weeks after leaving the risk area

Take Paludrine (daily):

• Once daily during the week before you go
• Once daily each day you are there
• And once daily four weeks after leaving the risk area

Buying anti-malarial treatments

Malaria is a disease you put yourself at risk of catching if you choose to visit areas where it is prevalent. This means that the NHS does not tend to provide anti-malarial medications free of charge and in most cases your doctor will not issue an NHS prescription. The cost of sourcing the medications is paid in full by the individual who may also need to source a private prescription.

Before buying anti malaria tablets talk to your doctor about the area you plan on travelling in and how long you are going away for, so they can advise you on which medications to take. Your doctor will ask if you are pregnant or taking any other medications to make sure there are no contraindications.
Some anti-malarial treatments can be bought over-the-counter, but most require a doctor’s prescription.

Avoid being bitten

Take steps to prevent being bitten by mosquitors. Cover up with long tops and trousers, preferable light coloured garments, between dusk and dawn as mosquitoes bite more in this period of the day. Where possible sleep in rooms where windows have a mosquito screen or sleep under a mosquito net, and spray your room with insecticide. Use an insect spray containing DEET a powerful repellent.

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