QUESTION:

I am a healthy senior citizen (73 years) and I am considering a trip with Semester at Sea. One of the ports they plan to visit is Ghana. I see the CDC says Ghana is a “high risk” area for malaria.

I think I remember being told (at the U of W Travel Medicine Clinic) a few years ago that the malaria drugs are problematic for Seniors.

With the Semester at Sea ship stopping at Takoradi, Ghana, how high a risk is malaria and what preventative measures could/should I take?

I have had no malaria treatment (preventive or due to illness) in the past.

Thank you.

ANSWER:

It is correct that Ghana is a high risk zone for malaria, and wise of you to investigate ways to prevent infection. This is especially the case given that there is evidence to suggest that senior citizens and travellers over the age of 60 may be more at risk of serious complications from malaria. As such, it is especially important for these high risk groups, which also includes pregnant women and children, to be well aware of ways to reduce the risk of exposure and infection.

Having said that, I have done some research and I don’t think there is any evidence that the standard drugs for preventing malaria work less well in older people. In fact, one study I found suggested that younger people were more likely to report side effects from taking malaria preventative medicine (see Mittelholzer et al., “Malaria prophylaxis in different age groups” in volume 3 of the Journal of Travel Medicine, published in 2006).

The only potential problem could be cross-reaction of the malaria drugs with other prescribed medicine. As such, I would recommend you enquire with your doctor prior to the trip, to ask about being prescribed drugs to prevent malaria that are appropriate for the region you are travelling to (probably Malarone, Lariam or doxycycline, since you will be travelling to an area with chloroquine-resistant forms of malaria) that furthermore won’t harmfully interact or have reduced efficacy when ingested alongside other medication you might already be taking.