Malaria prevention is complicated, so only trust a high quality travel clinic to prescribe the proper medications for your specific destinations and singular physiology.
Antimalarial drugs are designed to help prevent or cure malaria. Some of them can also be used to treat malaria until you get to a hospital.
However, they are not vaccines, and there is no guarantee of immunity from infection. You must also take other precautions, such as avoiding insect bites (listed above).
You can either get the drugs from your doctor or a clinic at home (expensive), but you can also buy them in tropical and Third World countries. If you can’t find the type you want in one place, try different pharmacies, or wait until the next country and look there.
There are so many types of tablets which you can take. Quinine is the oldest and most famous anti-malarial, however, the discovery of chloroquine has pushed it to the sidelines. Since then quite a few more anti-malarials have been developed and as a result it can get quite confusing without professional help.
For example, here is a list of drugs and brand names found from a basic search on the Internet:
- Quinine
- Chloroquine (Avloclor, Nivaquine)
- Amodiaquine
- Pyrimethamine
- Sulphadoxine
- Halofantrine
- Artemesinin and derivatives
- Doxycycline
- Clindamycin
- Fansidar (Pyrimethamine)
- Maloprim (Dapsone and Pyrimethamine)
- Dariprim
- Paladrim
- Paludrine (Proguanil Hydrochloride)
- Primaquine
- Mefloquine (Lariam)
- Malarone (Atovaquone and Proguanil)
To make it even more confusing you may need to take more than one pill, depending on which areas you are travelling to, as malaria is resistant in some areas of the world to ordinary chloroquinine.
You usually begin taking the medicines from about one week to a few days before exposure, and two to four weeks after your last exposure. Usually you take them only once a week but some you have to take every day.
There are some potentially dangerous, although rare, side-effects associated with all of the above. However, these are far outweighed by the dangers of getting malaria. If you are going to be exposed for a few months you should take pills.
Here are some typical drugs, recommended by the WHO, the UK HPA and the CDC for adults and children aged 12 and over, and the associated regimens and side effects.
Please note these are not recommendations, just information I have found out during my own research. New drugs come out all the time, so do your own independent research as well as reading this:
Chloroquine (Avloclor, Nivaquine, etc.) and Proguanil
What – take both or either, depending on the region you are going to, Chloroquine 300 to 310 mg once weekly, and Proguanil 200 mg once daily.
When – start one week before entering a malarious region and continue for four weeks after returning.
How long – may be taken for periods exceeding five years.
Side effects – can cause nausea, temporary blurred vision and rashes.
Doxycycline
What – 100 mg once daily.
When – start one day before entering a malarious region and continue for four weeks after returning.
How long – can be taken for periods up to six months.
Side effects – risk of photosensitisation (skin sensitivity to sunlight), can make you prone to sunburn.
Mefloquine (Lariam)
What – 228 to 250 mg once weekly.
When – start two and a half weeks before entering a malarious region and continue for four weeks after returning.
How long – can be taken for periods up to one year.
Side effects – can precipitate psychiatric disturbances in patients with a history of these conditions.
Malarone
What – 1 tablet daily.
When – start one day before entering a malarious region and continue for 1 week after returning.
How long – malarone can be used for travel periods up to one year.
Side effects – virtually free of side effects.
For a great website listing the current recommended drug regimens for different parts of the world, plus a list of dosages, advice on long-term use, and so on, click here.
