DoH Guidelines: Prophylaxis
[Treatment] [Prophylaxis]

 

TABLE  1: ANTIMALARIAL DRUGS FOR USE AS PROPHYLAXIS

RECOMMENDED DRUG

ADULTS

CHILDREN

CHLOROQUINE-SENSITIVE AREAS

Chloroquine

(e.g.  Anoclor®, Daramal®, Nivaquine®, Plasmoquine®, Promal®)

(1 tablet = 150 mg  chloroquine base)

300mg base (2 tablets) once every 7 days, starting 1 week before  entering the area, once weekly while in the area, and once weekly for 4 weeks after  leaving the area.

5 mg/kg of body  weight taken at the same intervals as for adults.

  

Age (year)

 Weight (kg)

 Dosage

 <1

 <10

 ¼-½  tablet

1-4

 10-19

 ½ tablet

5-8

 20-30

1 tablet

9-15

 31-45

 1½ tablets

 >15

 > 45

 Adult dose

Two strengths of chloroquine syrup are available for children (37,5 mg chloroquine base  per 5 ml and 50mg chloroquine base per 5 ml). The dose is 5 mg/kg to be taken at the same  intervals as for adults. See package insert for dosages.

CHLOROQUINE-RESISTANT  AREAS

Chloroquine (see  above)+ Proguanil (Paludrine®)

Chloroquine as above.

Proguanil

(1 tablet = 100mg proguanil)

200mg (2 tablets) daily starting 1 day before entering the area, continuing daily while in the area and daily for 4 weeks after leaving the area.

Chloroquine as above.

Proguanil - 3mg/kg of body weight at the same intervals as for adults

 

Age (years)

 Weight (kg)

 Dosage

 <1

 <10

 ¼

1-4

 10-19

 ½ tablet

5-8

 20-30

1 tablet

9-15

 31-45

 1½ tablets

 >15

 > 45

 Adult dose

OR

Mefloquine (Lariam®)

(I tablet = 250 mg  mefloquine)

250mg (1 tablet) every 7 days, starting 1 week before entering the area,  once weekly while in the area, and once weekly for 4 weeks after leaving the area.

Restrict use to 1 year.

Not recommended for  children under 2 years or who weigh less than 15kg.

5mg/kg of body weight taken at the  same intervals as for adults.

  

Age (years)

 Weight (kg)

 Dosage

2-4

 15 - 19

 ¼ tablet

5-8

 20 - 30

 ½ tablet

9-15

 31 - 45

 ¾ tablet

>15

 >45

 Adult dose

  

OR

Doxycycline*

(e.g.  Bok-c-lin®, Cyclidox®, Doxycyclin®, Doxylets®,

Doxymycin®, Dumoxin®, Theodox®,Viacin®, Vibramycin®)

 

 

 

(I tablet = 100 mg  doxycycline)

(1 capsule = 50mg , 100 mg or 200 mg doxycycline)

100mg once daily starting 1 - 2 days before entering the area, continuing daily while  in the area, and daily for 4 weeks after leaving the area. Not to be used for longer than  3 months.

Contra-indicated in  children under 8 years.

3mg/kg of body weight at the same intervals as for adults.

  

Age (years)

 Weight (kg)

 Dosage

8-15   

 31-45   

 Depending  on strength of tablet

>15         

 > 45 

  Adult dose

* Doxycycline should only be used if  other drugs are unsuitable.

The  guidelines are endorsed by the Medical Association of South Africa.

Compiled by the Department of Health in  collaboration with the Subcommittee for Chemoprophylaxis and Therapy of the National  Malaria Advisory Group.

October 1996