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.
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