General Information

Despite the availability of preventative medication to combat malaria and other simple ways to protect against mosquito bites, some confusion still exists as to how malaria can be prevented. Some people wrongly believe that by using preventative medicines, symptoms of the disease will be masked, making it difficult to detect. Others think it is not necessary to take preventive medicine when staying in malaria areas for a short period. Many more do not take malaria seriously at all, even when traveling in game parks in South Africa. Unfortunately, the fact is that although preventable, malaria continues to be one of the biggest killers of people around the world. For protection, the World Health Organization and Department of Health recommends that people take protection against mosquito bites when in an endemic area. Among others, in chloroquine - resistant areas they recommend preventative combination drugs containing chloroquine (DARAMAL) and proguanil (PALUDRINE), especially during the high risk malaria season, which is from October to May.

Signs and Symptoms of Malaria

The incubation period varies from 7 to 30 days. The incubation period could, however, be prolonged in patients who have taken malaria prophylaxis irregularly or for an insufficient time after exposure to the infection.

The fever occurs every second or third day depending on the parasitic strain and development of the infection. Initially malaria symptoms mimic a mild "flu-like" illness: shivering attacks, headaches, fever, muscular pains, nausea, diarrhea, fatigue, and sore throat or a cough. If left untreated, the symptoms will increase in severity and complications will arise.

Non-drug Measures to Beat the Mosquito Bite

Mosquitoes mainly feed from dusk to dawn. Preventative measures should be a top priority during this time. If possible, avoid being outdoors at this time, wear long sleeves, trousers and socks to cover ankles. Apply insect repellent containing diethyl-m-toluamide (deet) or dimethyl-phthalate to exposed skin. Use door and window screens and bed nets impregnated with insecticide. Travelers staying in well-built, well-maintained buildings are at the least risk. Visit malaria areas during the dry season.

Drug Measures & Prevention

One of the advantages of taking drug prophylaxis is that, if malaria does develop, the intensity and severity of the malaria is usually reduced. Drug compliance is essential and failure is estimated to be responsible for many infections which contributes to the increase in drug resistance. Drug choice according to patient factors for chloroquine-resistant areas are: Mefloquine Chloroquine & Proguanil Doxycycline.

Cautions of Use in Particular Health Conditions

• Pregnancy - Avoid during first trimester. Can be used from 4th month on.
• Young children - Can be used in children >15kg well tolerated by children. Safe to use in infants. Use only in children >8 years of age.
• Epilepsy - chloroquine may cause seizures (rare) May interact with anticonvulsants.
• Psychiatric conditions - It is contraindicated.
• Psoriasis - May exacerbate psoriasis.
• Interacts with oral contraceptives.