January 31, 2023

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Summer, Travel and Medication – Part 5 – Malaria

Prevention of malaria.

The anopheles mosquito stings only between sundown and the rising of the sun. There are some very effective precautions possible to avoid being stung by the mosquitoes: wear light colored clothing, covering the arms and legs; sleep under a mosquito net that has been impregnated with special substances like permethrine or deltamethrine; cover the exposed parts of the body every four to six hours with an insect repellant, preferably one on a DEET basis (Diƫthyltoluamide). The optimal concentration of DEET lies between 20 and 50%. Pregnant women and children are advised to use the 20% concentration. It is also advisable, especially for pregnant women and children to wash of any remaining insect repellant, once protection is no longer needed.

Medication

Anti-malaria medication has a lot of contra-indications as well as a lot of adverse effects. Prevention of malaria through medication is not simple since resistance has developed for the chloroquine and proguanil medication. Not one substance, how effective it might be has a 100% protection rate.

It is extremely dangerous for pregnant women to get infected by malaria: dangerous as well for the mother as for the unborn child. In very small infants a malaria infection can be fatal. That is why the WHO advises against travel to regions where malaria is endemic and thus the possibility for transmission is very high for pregnant women and families with young children.

When anti-malaria drugs are taken, they are not passed on through breastfeeding: this means that the newly born has to be given his own dose of anti-malaria drugs.

One can develop a natural immunity, but only after repeated infections, during a number of subsequent years. The immunity disappears very fast (usually within six months)when there is no longer exposure to the malaria infectors. Therefore every traveler, even people visiting their own native country should be considered non-immune.

One should be very aware of possible malaria when a high fever develops up to three months after the return from the tropics. It is a fact that every year fatalities are to be counted because people do not react on time.

Travelers coming from tropical regions where malaria is endemic have to wait for at least six months before the can donate blood, that is to be used either as a total either for some blood components. Diagnosed malaria patients have to wait three years. This restriction does not apply however for plasma donation.

This was part 5 of a series of 6 articles about travel and medication. The other parts being: Part 1 Vaccinations – Part 2 Travelers diarrhea – Part 3 Lyme’s disease – Part 4 mountain sickness and heat stroke – Part 5 Malaria – Part 6 motion sickness and jet lag.