Is malaria a problem for a tourist in Guyana?

by

QUESTION

Is malaria a problem for a tourist to Guyana?

ANSWER

Yes, malaria is something you should be aware of when travelling to Guyana. Transmission occurs in all areas under 900m in Guyana, including Georgetown. If you are visiting these areas, you should consider taking prophylactic medication to prevent malaria, such as atovaquone-proguanil (sold as Malarone), doxycycline or mefloquine (Lariam). You should also consider other preventative measures while you are there, such as sleeping under a bednet, wearing long-sleeved clothing (especially in the evenings and at night) and covering exposed skin with insect repellent.

Chloroquine Resistant Malaria

by

QUESTION

What is chloroquine resistant malaria?

ANSWER

Chloroquine-resistant malaria is exactly what it sounds like—particular types of malaria which are not cured by treatment with chloroquine.

Chloroquine was first discovered in the 1930s in Germany and began to be widely used as an anti-malaria post-World War II, in the late 1940s. However, resistance to the drug also rapidly emerged, with the first cases of Plasmodium falciparum not being cured by administration of chloroquine being reported in the 1950s.

Since then, resistance has spread rapidly (since obviously it is beneficial to the parasite to be resistant, so various mutations conferring this protection have arisen multiple times in different areas in the world and also been passed on preferentially to new generations of malaria parasites), and now chloroquine resistant P. falciparum can be found globally in malaria-endemic areas.

Chloroquine resistance in Plasmodium vivax has also now arisen, though more recently—the first reports came from 1989, in Australia, in travellers returning from Papua New Guinea. Now, chloroquine resistant forms of P. vivax are found in multiple locations in south-east Asia, such as Myanmar and India, as well as from Guyana in South America.

Nowadays, other drugs, and notably ones containing artemisinin-based compounds, are preferentially used to treat uncomplicated malaria and especially in areas where chloroquine resistance is known to occur. However, due to fears of resistance to these compounds also developing, the World Health Organisation recommends that artemisinin-based compounds only be administered in conjunction with other anti-malaria drugs, such as lumefantrine (which in combination with artemether forms the widely-used anti-malarial treatment Coartem). These combinations are known as artemisinin-based combination therapies, or ACTs for short.