Malaria occurs mainly in tropical and subtropical regions of the world. It iscaused by a protozoal parasite (Plasmodium spp) transmitted by the bite of the female Anopheles mosquito. Since the female mosquito lays her eggs in water, warm seasons aid the breeding process. It is therefore safer to visit a malaria area during the dry, cooler months.

Seasonal outbrakes of malaria occur in the northern and eastern Transvaal (Kruger National Park), northern Kwazulu-Natal, and Upington/Kakamas districts. Malaria areas in southern Africa include: northern Namibia, Malawi, Botswana, Zimbabwe, Mozambique and Swaziland. Besides Africa, many other countries in Asia, South, North and Central America are also at risk.

WHEN MAKING TRAVEL ARRANGEMENTS, IT IS WISE TO ASCERTAIN THE STATUS OF THE COUNTRY AND AREA SINCE THE DISTRIBUTION OF MALARIA DOES CHANGE.

Different forms of the disease (based on tecurrence of attacks) occur and geographical distribution is important when considering preventative medication. To complicate matters, some strains of malaria parasites have developed resistance to certain medicaments. This situation is not static

and it is therefore essential that medication is effective fot the particular area being visited. Many areas in southern Africa are now chloroquine-resistant.

PROPHYLAXIS FOR TRAVELLERS

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Many products are available for the prevention of malaria (supressive treat-ment). Although dosage do differ, certain principles are common to all. Medication must be taken before entering the malarial area, maintained whilst you are there and continued for four to six weeks after returning to a non-malarial area. Doses should be taken regularly at the same hour (if taken

daily) or on the same day (if taken weekly) and preferably with liquid after meals to minimise the gastro-intestinal disturbances associated with certain medicaments.

The choice of preventative medication depends on numerous factors such as geographical area, time of year, age of the patient, pregnancy, breast-feeding, etc.

AN ATTACK OF MALARIA (RESISTANT STRAIN) CAN OCCUR DESPITE HAVING TAKEN PROPHYLACTIC MEDICATION. MEASURES TO PREVENT MOSQUITO BITES REMAIN THE MAINSTAY OF PREVENTION.

As the correct choice of medication changes from time to time, patients must always check with their pharmacists as to which medication to use. The following medicines (singly or in combination) are commonly used for the prevention of malaria: 

  Active                             Trade names                        Dosage 

Ingredient                                                                   Frequency

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Chloroquine                      Anoclor, Daramal,                Weekly

(Sulphate or                      Nivaquine, Plamoquine,

phosphate)                        Promal

Mefloquine                        Lariam                                 Weekly

(hydrochloride)

Proguanil                          Paludrine                               Daily

(hydrochloride)

ADDITIONAL PREVENTATIVE MEASURES

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* Wear light-coloured clothing which covers the arms and legs.

* Apply a suitable insect repellent to exposed skin.

* Limit exposure before dawn and after sunset.

* Burn mosquito coils, vapour mats and use bednets impregnated with suitable insecticide in    bedrooms at night.

* Screen opeings (doors, windows) to living quarters.

* Avoid perfumes or after-shave lotions.

Report any flu-like symptoms such as fever, headache, fatigue, nausea, muscular and joint pains, sweating/shivering to your medical practitioner immediately and inform hm/her of having visited a malarial area. High risk persons ie the elderly, pregnant woman, babies, children under the age of

five and immuno-compromised individuals should avoid visiting malarial areas. Your pharmacist with his/her expertise in the safe and effective use of medicines, can advise you on -

* The appropriate dose and frequency of administration (eg breast-fed infants still need medication);

* the control of other effects eg nausea, allergies, increased sensitivity to the sun;

* the likelihood of drug interactions with other medicines.

KEEP ALL MEDICINES OUT OF THE REACH OF CHILDREN.

Copyright (c) 1995 South African Druggists Ltd.

(r) Registered Trademark South African Druggist Ltd.