Malaria
Malaria is a parasite spread by mosquitoes which first infects the liver before moving on to infect red blood cells. It is widespread in many tropical and subtropical countries affecting over 500 million people per year, and is a very serious and sometimes fatal disease.
It is one of the most important things to consider when reviewing your health needs before you travel as every year nearly 2000 cases are brought back to the UK.
You cannot be vaccinated against malaria, but you can protect yourself in four ways: These are sometimes known as the ABCD of malaria prevention which stands for:
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A - Awareness of the risk
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B - Bite avoidance
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C - Comply with Chemoprophylaxis (or anti malaria medication)
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D - Diagnosis – being aware of the symptoms
Bites avoidance
Mosquitoes cause much inconvenience because of local reactions to the bites themselves and from the infections they transmit. Mosquitoes spread malaria, yellow fever, dengue and Japanese B encephalitis.
Mosquitoes bite at any time of day but most bites occur in the evening.
Precautions to take:
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Avoid mosquito bites, especially after sunset. If you are out at night wear long-sleeved clothing and long trousers.
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Mosquitoes may bite through thin clothing, so spray an insecticide or repellent on them. Insect repellents should also be used on exposed skin. DEET is the most proven insect repellent, though has to be applied every few hours.
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Spraying insecticides in the room, burning pyrethroid coils and heating insecticide impregnated tablets all help to control mosquitoes.
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If sleeping in an unscreened room, or out of doors, a mosquito net (which should be impregnated with insecticide every 6 months ) is a critical precaution. Portable, lightweight nets are available from the health centre.
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Garlic, Vitamin B and ultrasound devices do not prevent bites.
Chemo-prophylaxis or taking anti-malaria tablets
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Start before travel as guided by your travel health advisor (with some tablets you should start two to three weeks before).
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Take the tablets absolutely regularly, preferably with or after a meal.
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It is extremely important to continue to take them for four weeks after you have returned, to cover the incubation period of the disease. (For most this means four weeks but with the newest drug Malarone only seven days post-travel treatment is required)
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The commonest anti-malarial tablets used are listed below.
Most common anti-malaria tables
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Medication
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How long before entering malarious area?
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How long after departing malarious area?
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Chloroquine
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2 weeks
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4 weeks
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Proguanil
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1-2 doses before departure
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4 weeks
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Mefloquine
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2-3 weeks
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4 weeks
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Malarone
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1 day
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7 days
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Doxycycline
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2 -7 days
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4 weeks
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Many locals won’t take anti–malarial medication in areas you visit. This is because they will have had repeated infections and people do eventually build up partial immunity to the disease. You cannot assume it is safe for you to do the same as travellers from non malarious countries will have no immunity.
Diagnosis and prompt treatment
Following these guidelines faithfully might not guarantee complete protection. If you get a fever between one week after first exposure and up to 4 months after your return, you should seek medical attention and tell the doctor that you have been in a malarious area. Classically you have the symptoms of flu with shivers and aching joints, but you can also get headaches, stomach pains and diarrhoea.
More information on malaria can be found at Malaria Hotspots.
The above information is aimed at UK residents and is a guide only. The University of Nottingham Health Service accept no liability for the contents of these web pages. If you have questions or concerns you should seek advice from a qualified medical practitioner.