This information was provided by
The Malaria Research Programme of the Medical Research Council, South Africa
The best prevention is personal protection against the mosquito. Malaria mosquitoes generally bite after dark. Wear long sleeves and trousers in the afternoon and evening; stay in-doors if possible. Use insect repellent on exposed skin. Sleep under a bednet or in a netted tent or hut or in a house or caravan with screens. Close windows and doors at night. Spray insecticide aerosol and/or burn mosquito coil at night.
Get good advice before you plan your holiday. The appropriate prophylaxis for a given malaria area depends on several factors including:
Take the pills same day each week when weekly, or at the same
time of the day if daily.
Continue prophylaxis for 4 weeks after your return. Complete the course.
Mefloquine (Lariam®) has been taken by people up to 12 months
without side effects, is highly effective and has a simple weekly dosage. However,
it has a number of contra-indications and requires a doctor's prescription.
It also has been known to have rare but severe neurological side effects.
Start a week or two before, to check for possible side-effects and continue for 4 weeks after leaving the area. Mefloquine should be taken on a full stomach.
This drug is highly effective in SE Asia where there is multi-drug resistance, and resistance is rare. However, it is for short term use only and can cause light sensitivity. Doxycycline should only be taken if other drugs are unsuitable. It has been known to render birth control pills ineffective when taken at the same time.
This combination should be used with caution as resistance has
developed in Mozambique and other regions. Proguanil (Paludrine®) every
day; Chloroquine (Daramal® / Nivaquine® / Promal® ) once a week.
This combination can be taken safely up to 3 months, very cautiously for 6.
Start a day before entering the malaria area, and continue for four weeks after you leave the area. It is generally well tolerated and is available without prescription. Disadvantages are poor compliance due to the complicated regime and widespread resistance particularly in SE Asia.
Test yourself immediately on first malaria symptoms.
There are several good rapid tests available now . Don't leave home without one.
When travelling in Africa, make sure you have everything with you.
When you get malaria head for the nearest doctor. Show your test and ask to be treated.
If you have contracted malaria in spite of prophylaxis you will need Lumafantrine-artemether or quinine. Sulfadoxine-Pyrimethamine (Fansidar«) may suffice. But be aware that Sulfadoxine-Pyrimethamine resistance exists. Refuse chloroquine treatment.
For the worst-case scenario, take along some Lumafantrine-artemether. If you get stuck and cannot get to a doctor, treat yourself.
This is for emergency situations only.Always seek medical help if at all possible.