Malaria – Malarone

For which areas is Malarone recommended? Malarone is effective in areas of the world where we are seeing increasing Chloroquine resistance.

Dosage: one tablet per day, starting just 1-2 days prior to arriving in a malaria zone, while away and for just 7 days on leaving the area. This is because Malarone has the ability to act on the liver and blood stage of the malaria infection. This simple regime is believed to increase compliance and will be especially convenient for short holidays and last minute trips to malarial destinations.

Often travellers become concerned if they discover they have been given a different anti-malarial to other people on the same plane going to the same destination. This often happens because there are usually several options for the same destination and the final choice is based on several different factors including price…

The Malaria Reference Laboratory is responsible for drawing up the anti-malarial recommendations for the UK. Each recommendation involves looking closely at epidemiology of the disease, resistance to the malarial parasite and of course the number of cases that are coming out of certain areas in a particular country. The guidelines then reflect the best ‘recommendations’ and alternatives as recommended in the UK. These guidelines are then published and updated on a regular basis and it is up to the travel clinic, practice nurse or doctor to keep up to date with the changes within the UK recommendations.

Now, that is not the whole story – recommending the ‘right’ drug for each person involves a lot more than just looking at a chart and pulling out a drug name. Making a full assessment of each individual and recommending the right drug for a particular individual traveller is often the difficult part.

It is important that when visiting a health professional for advice on anti-malarials that you give them enough information to work with. They need to know where you are travelling to – and be specific; recommendations can differ within a single country or area. Let them know about any stopovers, are you staying in a rural area or in a city – malaria is less of a threat in the cities. What will your altitude be? Malaria is not often found above 2000 metres, although reports from East Africa would suggest changes are occurring in certain parts of the globe.

The time of year is also an important consideration as malaria is seasonal in some areas. The worldwide climatic variations have brought about changes in the pattern of malaria over the last few years. Your health professional will need to know how long you are going to be away as well as your age, and also of importance is the types of medication you are taking and your past medical history.

And that is not the full story – no anti-malarial, however much media attention it receives, is going to be 100% effective and it is important that you also take into consideration how you can prevent getting bitten by mosquitoes in the first place! Recommendations are as they suggest ‘recommendations’ which, when discussed with your health advisor, might differ from the person sitting next to you on the plane – but it doesn’t always mean they’ve got it wrong…

 


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.