Health – Malaria Prophylaxis

Malaria Prophylaxis

Background

When considering malaria risk, travellers should bear in mind that NO Anti-malarial provides 100% protection against the disease. Thus, avoiding mosquito bites remains the cornerstone of protection against malaria. DO NOT GET BITTEN!

Although no Malaria Prophylaxis provides 100% cover, one should consider that 90% protection is better than no protection at all. Therefore, the use of Malaria Prophylaxis is highly recommended as a second line of defense against malaria.

There are various myths surrounding malaria prophylaxis ranging from Gin being a good substitute, to prophylaxis masking the symptoms from medical experts. To find out the truth about prophylaxis and its effects, travellers should consult their nearest Travel Doctor.

 

Myths and Truths

Myth: Gin & Tonic (G&T) works just as well as any prophylaxis.
Truth: Gin (or any other alcohol for that matter) does not provide any protection against the malaria parasite. Tonic water (which contained quinine) however, was historically used as malaria prophylactic. Considering that Tonic water today contains extremely small quantities of quinine, one would need to consume G&T in units of multiple litres per hour to provide any significant level of protection.
Myth: Prophylaxis makes the disease undetectable.
Truth: Although malaria prophylaxis is supposed to eliminate malaria parasites, most modern laboratories can still detect the disease in the blood of a victim. In most cases a negative result with continued illness will warrant a second and third blood smear examination. In fact, the World Health Organisation (WHO) recommends 7 tests to completely eliminate the possibility of Malaria. If you suffer a malaria infection, it will be found, even while taking prophylaxis.
Myth: All prophylaxis has the same side effects.
Truth: Most travellers don’t suffer any side effects from prophylaxis. However, because we are each biologically unique, some travellers may experience side effects. Different anti-malarial tablets will have different side effects for those that experience them. The best choice of tablet should be made in consultation with a travel health specialist such as the Travel Doctor.
Myth: Frequent travellers can become immune to malaria.
Truth: People born in malaria-endemic areas become partially immune because of frequent infection, but the mortality rate amongst babies and toddlers remain extremely high. Travellers never become immune – in spite of frequently being infected – and they are in danger of dying every time they contract malaria.

Prophylaxis Options

No malaria prophylaxis offers complete protection from the malaria parasite, but chosen and applied well, the combination can provide 90% protection against malaria illness and death. It has been shown that even if illness does occur, the likelihood of cerebral malaria is diminished, and the chance of death reduced significantly.

Options include: Mefloquine (becoming more difficult to obtain in RSA), Doxycycline and Atovaquone & Proguanil.

Regimen

Product Before Exposure During Exposure After Exposure
Mefloquine 1 week prior to departure 1 tablet weekly 4 weeks after
Doxycycline 2 days prior to departure 1 tablet daily 4 weeks after
Atovaquone & Proguanil 2 days prior to departure 1 tablet daily 1 week after