Prescribing Malaria Prophylaxis For Travellers to Sub-Saharan African Countries

Written by Administrator

Some Facts ... Chloroquine &/or Proguanil are not adequate as prophylaxis in ANY of these countries due to widespread Chloroquine resistance. They should never be considered as first-line prophylaxis for this reason. Appropriate malaria prophylaxis for such areas would include Malarone, Mefloquine or Doxycycline, - the age, and health status of the traveller (and weight in the case of children) will determine which is the best option in each individual case, and so a careful/ thorough history must be taken for each individual concerned. In children it is very important that their weight has been accurately measured in order to ensure correct dosage calculations. Weight is a more accurate measure than age in such calculations. Of particular note pregnant women and young children must be very carefully assessed before malaria prophylaxis is prescribed. It should be noted that it is medically recommended that women AVOID travel to high-risk malaria countries during pregnancy as the risks to both mother and foetus are so great.   If however the pregnant traveller chooses (against medical advice) to proceed with her trip she has only one option of   effective prophylaxis -   Mefloquine - but this may be contra-indicated either if she has a psychiatric condition or is suffering from depression, and also it is not licensed for use during the first three months of pregnancy. For children the choice of malaria prophylaxis will be in part based on their weight. Mefloquine cannot be prescribed until a baby reaches a weight of 6 kg and Paediatric Malarone cannot be prescribed until a child has reached 11 kg. Doxycycline is contra-indicated until a child reaches age 12, due to its effects on the development of bone and teeth.   The medical history of the child must also be considered when deciding which is their best option.

Last Updated ( Wednesday, 15 August 2007 )

 

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