Malaria: Prevention, taking pills

Chemoprophylaxis is in the first instance intended as prevention of P. falciparum malaria. No single drug which is taken preventively, is 100% active against sporozoites and no single drug prevents the formation of liver forms (except primaquine). While taking the drugs no vivax or ovale malaria will occur, but after they have been discontinued an attack with these plasmodia is possible in the following months or years. In view of the extensive resistance of P. falciparum, at present no 100% satisfactory protection against this latter parasite is possible. Advice as to whether or not to take medication, and which kind of drug to take, will depend on the region and differ from person to person (short journeys, resident, local population, pregnancy, young children, allergy, chronic diseases, use of other drugs and so on). Recommendations vary from country to country.

In regions with only P. vivax and/or sensitive P. falciparum (WHO zone A) chloroquine 300 mg/week will suffice. In zone B a combination of chloroquine (Nivaquine®) 300 mg/week and proguanil (Paludrine®) 200 mg/d is recommended. If necessary chloroquine 100 mg/day can be taken with proguanil 200 mg/day (= 1 tablet of Savarine® daily). For shorter stays in zone C (<3>

In summary:

• Zone A : Chloroquine 300 mg per week

• Zone B : Chloroquine 300 mg per week + Paludrine 200 mg per day, or Savarine 1 per day

• Zone C : Lariam 1 tablet per week, or Vibramycin 100 mg per day, or Malarone 1 tablet per day

As alternative or supplement:

• Personal physical protection (impregnated mosquito net, repellents, clothing that covers, insecticides in rooms)

• Stand-by treatment (Malarone, artemether, quinine + vibramycin)

Category: Medicine Notes