Malaria
Malaria is a parasitic disease transmitted via a mosquito that bites from dusk until dawn. It remains a life- threatening infection and in 2019, there were an estimated 229 million cases of malaria worldwide and 409,000 deaths. It can present a very serious risk to travellers visiting the areas where the disease is present. A careful risk assessment will be completed by your travel health consultant, especially as certain travellers will be at a higher risk of severe disease (The elderly, immunocompromised, in pregnancy, certain medical conditions and children). The largest proportion of malaria cases are found in Africa, but it is present in South East Asia, Asia, Central and South America, Hispaniola (Dominican Republic and Haiti), the Middle East and Oceania. There are different species which can present a greater or lesser risk, however the advice in all malaria areas remains similar. Travellers should be aware of the ABCD approach to malaria prevention
A - Awareness of Risk – Is there Malaria is the area you are visiting? Is it transmission season and is it high or low risk?
B – Bite avoidance strategies – Repellents, mosquito nets, clothing, room protection and knock down sprays (See mosquito bite avoidance/ insect bite avoidance)
C- Chemoprophylaxis – Anti malarial medication –The right medication should be taken for the region that is visited and your personal health. Medication must be taken for the correct length of time. This varies depending on the medication and usually needs to be continued after the malaria areas has been left.
Diagnosis – Be aware of Symptoms – Fever, flu-like illness, headache, malaise, diarrhoea and Jaundice. If you develop these or any other worrying symptoms while away or on return to the UK, even if months afterwards, seek medical assistance and let them know you visited a malaria area.
Reference and to see further information -
NaTHNaC - https://travelhealthpro.org.uk/factsheet/52/malaria
For recommended antimalarial medication travellers need to look up specific country information for advice – The medications to consider -
Atovaquone 250mg/Proguanil 100mg combination preparation:
· start one to two days before arrival in the malaria risk area
· for adults, one tablet is taken every day, ideally at the same time of day for the duration of the time in a malaria risk area and daily for seven days after leaving the malaria risk area
· take with a fatty meal if possible
· for children pediatric tablets are available and the dose is based on body weight (see table below)
Doxycycline 100mg:
· start one to two days before arrival in the malaria risk area
· adults and children over 12 years of age take 100mg daily, ideally at the same time of day for the duration of the time in a malaria risk area and daily for four weeks after leaving the malaria risk area
· take with food if possible; avoid taking this drug just before lying down
· not suitable for children under 12 years of age
Mefloquine 250mg:
· this drug is taken weekly, adults take one 250mg tablet each week
· start two to three weeks before arrival in the malaria risk area and continue weekly until four weeks after leaving the malaria risk area
· for children the dose is based on the body weight (see table below)
