Malaria is one of the very dangerous tropical infections one can get while travelling into an affected area. It is caused by a parasite, which is transmitted by mosquitos. The symptoms of this disease are mostly harmful and paralyzing. Fever, diarrhoea and general pain are the main symptoms of a Malaria infection. The time for the breakout may need only one week but the manifestation of this disease can take a very long term. But there is a possibility to prevent an infection with antibiotic medication. Some drugs are designed for fighting an infection during and after a stay in an affected area. They work cause they block and constrain the activity and the ability of reproduction of the parasite.
If you consider travelling to a tropic country you should think about a possible medication. Before travelling you should check out the kind of malaria which is present in this area because different medication is made for different kinds of parasites.
Malaria is a life-threatening disease, typically from tropical climates that can spread by the bite of a mosquito. It is a serious disease because if will not be diagnosed and treated right away, it can lead to death.
One single bite is enough to infect someone.
What are the symptoms of malaria?
When you are travelling to areas with a high risk to infect, it is very important to pay attention if you have any symptoms below:
- pain in the muscles;
- chills and sweats;
- fever (a high temperature in your body);
The symptoms of malaria typically develop within 7 days to 18 days following the infection. In some people, symptoms may not develop for several months or up to a year, and even longer.
When to see your GP
During or after you travel to an area with risk and you feel the symptoms, you should go to the doctor immediately. Even if you feel any symptoms weeks, months or year later, you should go to the doctor and seek for medical help.
To confirm if you have malaria, you need to do a blood test, which will show if you were infected. The result of the test, usually, will be ready on the same day. If the test confirmed positive for malaria, you need to start the treatment immediately.
Malaria can occur if a mosquito infected with the Plasmodium parasite bites you. There is an extend family of plasmodia parasites, but in humans, just five different types can cause malaria.
It is very rare, but this disease can also be spread through using the same needles or blood transfusion.
Malaria transmission (by Plasmodium parasite) occurs primarily between dusk and dawn because of the nocturnal feeding habits of female Anopheles mosquitoes. When this mosquito bites you, the parasite is released into your bloodstream.
Malaria: Where is the risk areas?
Malaria is typically found in tropical areas of the world. It can be included more than 100 countries, as follow:
- Dominican Republic and Haiti;
- South and Central America;
- some parts of the Middle East;
- some islands in Pacific;
- large areas of Asia and Africa;
According to the publication in the World Health Organization (WHO), in 2014, the World Malaria Report estimated that, all of the world, 198 million people had malaria and 584,000 deaths in 2013.
This disease does not happen in UK, but it is estimated that, in 2014, around 1,586 travelers, when they back to UK, were diagnosed with Malaria and three people died.
Malaria: How to prevent
If you are planning to travel to a city with malaria risk, you should talk to your GP. He can recommend you to take some antimalarial tablets, to not be infected.
There are some ways to prevent Malaria. You can use the ABCD approach to avoid this disease, as follow:
Awareness of risk of malaria– the first thing is be sure if you are going to malaria risk areas;
Bite prevention - you should use insect repellent and an insecticide treated mosquito net and you should cover your arms and legs to avoid the mosquitos bites;
Check if you would need to take malaria tablets - in case to take this tablet make sure are the correct one and the right dose and do the treatment until the end;
Diagnosis - if you feel the malaria symptoms, look for medical advice right away. It is important to go to the doctor even if you feel the symptoms one year later.
Antimalarial tablets can reduce the risk to get an infection by about 90%, therefore is very relevant avoid the mosquitos bites too.
It is very important to take the antimalarial tablets to reduce the chance of infection because there is no vaccine available for this disease.
It is also very important to take the right dose and finish the treatment. If you have doubts, the best option is to talk to a pharmacist or your GP to be sure how long you should keep the treatment.
When to use it:
Please use the tablets correctly, following all the instructions;
If you are not so sure, please talk to some pharmacist or your GP to get the right
medication before you go;
There is some antimalarial medication that, in order to cover all incubation period, it is necessary to take the medication for up to four weeks after you return from the trip;
Common side effects:
Make sure that your GP prescribed a medication that you can tolerate. There are some side effects that can happen with someone who:
- Has some type of seizure condition or has epilepsy;
- Takes medicine to prevent blood clots as warfarin;
- Has some mental health condition or has depression;
- Has AIDS or HIV;
- Uses contraceptive patches or contraceptive pill (combined hormonal contraception);
- Has kidney, heart or heart problems;
The antimalarial you will take depends which strain of malaria has inside the mosquito and if this mosquito is resistant to some types of the medication. Therefore, each time that you feel the symptoms you should talk to your GP. You cannot use the same medication more than one time without confirmation.
Chloroquine and proguanil, in the UK, can be bought in local pharmacies, directly in the counter. Nowadays, this medication is not so usual to be prescript by the doctor. So it is indicated to talk to your GP to get the right treatment.
The antimalarial medication: the main types
Please find below the main types of antimalarial to avoid malaria:
Proguanil with Atovaquone
Dosage – you should take the medication one or two days before the trip. During the time you are in a risk area you should take it every day, and then you need to take for more seven days after your return. Child dosage depends on his weight and it is once a day. In adult, the dose is one adult-strength tablet per day;
Recommendation – this medication is not recommended for woman who is pregnant or breastfeeding or for people with serious kidneys problems;
Common side effects – mouth ulcers, skin rash, headaches and stomach upset;
Other factors – this medication probably is more expensive to other types of antimalarial, so it is better to take it to short trips;
Doxycycline (also called Vibramycin-D)
Dosage – you should take the medication two days before the trip. During the time you are in a risk area you should take it every day, and then you need to take for more four days after your return. The dose is 100mg per day and can be found as capsule or tablets;
Recommendation – this medication is not recommended for woman who is pregnant or breastfeeding, for people with liver problems, for people sensitive to tetracycline antibiotics and for children under 12 years old (there is a risk tooth discoloration);
Common side effects – sunburn (when you are light sensitive), thrush, heartburn and stomach upset. It is better to take this medication with full stomach, and when sitting or standing;
Other factors – this medication is cheap than the other types. You can ask your GP, if you are already using this medication to acne, if the dosage is right then you are protected against malaria too;
Mefloquine (also called Lariam)
Dosage – you should take the medication three weeks before the trip. During the time you are in a risk area you should take it every day, and then you need to take for more four weeks after your return. Child dosage depends on his weight and it is once a week. In adult, the dose is one adult-strength tablet per week;
Recommendation – this medication is not recommended for people with liver or heart problems. It is not also recommended for people who have seizures, epilepsy, depression or other mental diseases or if you are close to someone who has these problems;
Common side effects – psychiatric reactions (hallucinations, panic attacks, depression or anxiety), headache, dizziness, sleep disturbances (vivid dreams and insomnia).
It is strongly recommended that if you had some of the health problems mentioning above, even a mild depression, please talk to your GP before taking medication. If you have seizure disorder you cannot take this medication.
Other factors – if you already got this medicine before it is better to do a trial 3 weeks before the trip ,to see if you will have some side effects;
Chloroquine and Proguanil
The combination of these two antimalarial medications is available, but nowadays is very rare to recommend, because the most common and dangerous type of malaria parasite (Plasmodium falciparum) is ineffective by this medication. Nevertheless, the combination of proguanil and chloroquine can be recommend to areas like India and Sri Lanka, when this type of Plasmodium falciparum parasite is not so common than other types.
- UK malaria treatment guidelines 2016.: website: https://www.ncbi.nlm.nih.gov/pubmed/26880088, last check 09. September 2017.
- Malaria : website: http://www.nhs.uk/Conditions/Malaria/Pages/Introduction.aspx, last check 09. September 2017.