QUESTION

I am emigrating (moving permanently) to Mozambique – Vilanculos in October after my marriage, I want to fall pregnant.

What medicine can I take to prevent malaria during my pregnancy in Mozambique? I am afraid of getting malaria while I am pregnant. I am from South Africa, will the doctors here have a remedy for me to take before I am moving to Vilanculos? Do you know of any malaria prevention during pregnancy medicine?

ANSWER

Certain drugs commonly used to prevent malaria are not appropriate for
pregnant women. Those which can be taken by pregnant women are
chloroquine and mefloquine (the latter is commonly sold as Lariam).
Unfortunately, the type of malaria found in Mozambique is resistant to
chloroquine, and so this drug is not recommended for people living in
this area. As such, mefloquine remains as the likely first choice
preventive drug for you when you get pregnant. Some studies suggest
mefloquine should not be taken in the first trimester of pregnancy,
but in high malaria transmission zones, the dangers of malaria may
outweigh these early risks. You can talk to your doctor about the pros
and cons of this. There are also no problems with taking it long term
(i.e. for the 9 months of pregnancy), and the Centers of Disease
Control in the US also state it is safe for infants to consume small
amounts of mefloquine, so it can be taken during breast feeding as
well. It is important to note that mefloquine is not recommended for
people with a history of certain psychiatric disorders, so you should
consult with your doctor before taking it if you have a history of
mental illness.

Throughout your pregnancy, you should also be aware of other methods
for preventing malaria, such as sleeping under a long-lasting
insecticide treated bednet, and making sure your house is fully
screened to prevent mosquitoes from entering. Wearing long sleeved
clothing in the evening and at night when you’re outside, and insect
repellent on exposed skin, can also help prevent mosquito bites.