Mefloquine

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QUESTION

My son, 7 years old, took Mefloquine course for malaria prevention last year. We are travelling to INdia again this year. Does he and myself need to repeat the anti-malaria pills again this year?

ANSWER

Yes. You need to take anti-malarial preventative medication every time you go back to a malarial area. It is also important to continue taking the drug for the required amount of time before and after returning from your trip—in the case of mefloquine, you need to start taking it two weeks before you depart for the malarial area, and then continue you taking it for 4 weeks after you get back. This ensures that if you are exposed to malaria at the beginning or end of your trip, you are still adequately protected.

If you have some time, we at Malaria.com would be very grateful if you would take a minute or two to answer our malaria survey that we are conducting about our readers’ experiences with anti-malarials, and particularly their side effects.

Malaria Prevention

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QUESTION

What are the ways in which you can prevent yourself from being infected with malaria?

ANSWER

Malaria prevention consists of a combination of mosquito avoidance measures (since malaria is transmitted by infected mosquitoes) and chemoprophylaxis (medication to prevent the establishment of malaria in your body, if you do get bitten). Although very efficacious, none of the recommended interventions are 100% effective.

Mosquito Avoidance Measures

  • Because of the nocturnal feeding habits of Anopheles mosquitoes, malaria transmission occurs primarily between dusk and dawn.
  • Contact with mosquitoes can be reduced by remaining in well-screened areas, using mosquito bed nets (preferably insecticide-treated nets), using a pyrethroid-containing flying-insect spray in living and sleeping areas during evening and nighttime hours, and wearing clothes that cover most of the body.
  • All travelers should use an effective mosquito repellent.
  • The most effective repellent against a wide range of vectors is DEET (N,N-diethylmetatoluamide), an ingredient in many commercially available insect repellents. The actual concentration of DEET varies widely among repellents. DEET formulations as high as 50% are recommended for both adults and children older than 2 months of age (see the Protection Against Mosquitoes, Ticks, and Other Insects and Arthropods section later in this chapter). DEET should be applied to the exposed parts of the skin when mosquitoes are likely to be present.
  • In addition to using a topical insect repellent, a permethrin-containing product may be applied to bed nets and clothing for additional protection against mosquitoes.

Chemoprophylaxis

      • All currently recommended primary chemoprophylaxis regimens involve taking a medicine before travel, during travel, and for a period of time after leaving the malaria endemic area. Beginning the drug before travel allows the antimalarial agent to be in the blood before the traveler is exposed to malaria parasites.
      • Presumptive antirelapse therapy (also known as terminal prophylaxis) uses a medication towards the end of the exposure period (or immediately thereafter) to prevent relapses or delayed-onset clinical presentations of malaria caused by hypnozoites (dormant liver stages) of P. vivax or P. ovale. Because most malarious areas of the world (except the Caribbean) have at least one species of relapsing malaria, travelers to these areas have some risk for acquiring either P. vivax or P. ovale, although the actual risk for an individual traveler is difficult to define. Presumptive anti-relapse therapy is generally indicated only for persons who have had prolonged exposure in malaria-endemic areas (e.g., missionaries, volunteers).
      • In choosing an appropriate chemoprophylactic regimen before travel, the traveler and the health-care provider should consider several factors. The travel itinerary should be reviewed in detail and compared with the information on where malaria transmission occurs within a given country to determine whether the traveler will actually be traveling in a part of the country where malaria occurs and if significant antimalarial drug resistance has been reported in that location.
      • The resistance of P. falciparum to chloroquine has been confirmed in all areas with P. falciparum malaria except the Caribbean, Central America west of the Panama Canal, and some countries in the Middle East. In addition, resistance to sulfadoxine–pyrimethamine (e.g., Fansidar) is widespread in the Amazon River Basin area of South America, much of Southeast Asia, other parts of Asia, and in large parts of Africa. Resistance to mefloquine has been confirmed on the borders of Thailand with Burma (Myanmar) and Cambodia, in the western provinces of Cambodia, in the eastern states of Burma (Myanmar), on the border between Burma and China, along the borders of Laos and Burma, and the adjacent parts of the Thailand–Cambodia border, as well as in southern Vietnam.
      • Additional factors to consider are the patient’s other medical conditions, medications being taken (to assess potential drug–drug interactions), the cost of the medicines, and the potential side effects.

The medications recommended for chemoprophylaxis of malaria may also be available at overseas destinations. However, combinations of these medications and additional drugs that are not recommended may be commonly prescribed and used in other countries. Travelers should be strongly discouraged from obtaining chemoprophylactic medications while abroad. The quality of these products is not known, and they may not be protective and may be dangerous. These medications may have been produced by substandard manufacturing practices, may be counterfeit, or may contain contaminants. Additional information on this topic can be found in an FDA document

Purchasing Medications Outside the United States.

Taking other Pills with Malaria Medication

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QUESTION

If Its okay to take ACE DIET supplements if Im taking MALARIA pills?

ANSWER

If you are taking natural ACE supplement pills, then the active ingredients are usually caffeine, cocoa and maybe green tea. None of these compounds has any observed interaction with malaria pills, so they should be safe to take at the same time. However, without knowing exactly which type of ACE pills and malaria pills you are taking, it is impossible to say for certain. You should consult your physician for specific advice on this matter.

vomiting

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QUESTION

Is it normal to be vomiting after taking malaria tablets?

ANSWER

Side effects are generally rare with most malaria medication, though vomiting is one of the more common side effects that have been reported. We at MALARIA.com are very interested in hearing about people’s experiences with malaria medication, so please take our malaria survey. Many thanks for your time!

 

Crystal Meth and Malaria Pills

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QUESTION

If you were on crystal meth and now take malaria pills, will the pills be canceled?

ANSWER

I am pretty sure there has never been any actual research on the effect of crystal meth (methamphetamine) on absorption of malaria medication. However, some compounds do interfere with the uptake of malaria medication, so it is possible that crystal meth could also have such an effect. Given the serious health consequences of using crystal meth, its effect on malaria medication is probably not as much of a concern as all of the other risks!

What is Malaria?

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QUESTION

What is malaria?

ANSWER

Malaria is a disease caused by parasites of the genus Plasmodium. Transmitted by mosquitoes, there are several different kinds of malaria distributed throughout the tropical and sub-tropical regions of the world, causing somewhere between 300-500 million cases of disease each year, and as many as 1 million deaths. In fact, malaria is one of the biggest killers of children under the age of five in sub-Saharan Africa, one of the regions of the world where the burden from malaria is the highest. Malaria is usually an acute disease, manifesting itself with severe fever, chills, headache and often nausea as well. Some types of malaria can have relapsing episodes over a time period of many years.

Having said this, malaria is easily preventable, through avoiding mosquito bites by wearing appropriate clothing and sleeping under insecticide-treated bednets, or through taking preventative medication (called prophylaxis). Malaria is also treatable once symptoms appear, through ingesting safe, effective and relatively cheap drugs. With such control measures at hand, you may ask why malaria is still such a huge problem in our world; the answer is that delivering control strategies and treatment to populations most at risk is difficult, and often countries with high malaria burdens don’t have efficient and effective health systems in place to coordinate control efforts.

International non-governmental organisations such as the World Health Organisation, as well as a multitude of non-profit organisations such as the Malaria Consortium and Malaria No More, work tirelessly to bring malaria control and treatment to the places that need it most, with the aim to eradicate malaria as a disease of public health importance.

Malaria effects on body’s digestive system

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QUESTION:

How does Malaria affect the digestive system?

ANSWER:

Malaria does not usually affect the digestive system directly, although nausea and abdominal pain can be symptoms of the disease, usually due to the high fevers caused by the infection. Having said that, some of the drugs given as treatment or prevention of malaria are also known to have gastrointestinal side effects; both chloroquine and proguanil (one of the active ingredients in Malarone) are known to cause nausea and abdominal pain as common side effects, and both can also sometimes (in rare cases) result in gastrointestinal bleeding. It is recommended that these medications be taken with food, to reduce the likelihood of experiences any such side effects.