Malaria

Malaria (Italian: "bad air"; formerly called ague or marsh fever in English) is an infectious disease which in humans causes about 350-500 million infections and approximately 1.3 million deaths annually, mainly in the tropics. Sub-Saharan Africa accounts for 85% of these fatalities.{{mn|OnePointThree|1}}

Travel to malaria-risk zones

Travelers to malaria-risk zones should first contact a physician whose speciality is in travel medicine. Most often a general practitioner cannot prescribe medications or give vaccinations for third-world travel. Seldom will malaria be the sole health concern, and the physician will need to assess all the health risks the traveler will face. Even before considering prophylactic medications, there are important anti-insect measures that should be used, such as impregnated bed nets and appropriate insect repellents. There are several drugs available for malaria prevention (many are also used in higher doses for treatment) including mefloquine, doxycycline, and Malarone. There is no one drug that is right for all travelers to all destinations. The choice of a malaria prophylaxis should be made carefully with one's physician taking into account drug resistance in the traveler's destination; possible side effects, interactions, and contraindications; and finally the preferred frequency per dose (daily, weekly, etc.).

Related Topics:
Physician - Travel medicine - Vaccinations - Third-world - Travel - Prophylaxis - Contraindications

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Travel to rural areas always involves more potential exposure to malaria than in the larger cities. (This is in contrast to dengue fever where cities present the greater risk.) For example, the capital cities of the Philippines, Thailand and Sri Lanka are essentially malaria-free. However, malaria is present in many other places (especially rural areas) of these countries. By contrast, in West Africa, Ghana and Nigeria have malaria throughout the entire country. However, the risk will always be lower in the larger cities. Travelers should never assume that their choice of malaria prophylaxis is available in the country that they will be visiting. Quinine is not recommended as a prophlactic antimalarial.

Related Topics:
Dengue fever - Philippines - Thailand - Sri Lanka - Ghana - Nigeria

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Any malaria prophylaxis must be taken before, during, and (especially) after traveling to a malaria-risk zone. The exact frequency will vary by which drug is chosen. There has been some debate recently over whether pre-travel malaria prophylaxis is being started early enough. For example, mefloquine is normally taken one week prior to travel. Some feel this is inadequate if the person is unfortunate enough to be exposed to malaria shortly upon arrival. Those who have concerns may wish to discuss with their physician about doubling the time period (not the dosage) that their malaria prophylaxis will be taken prior to travel. In addition to providing better protection, there will be more time to switch to another anti-malaria medication, if necessary.

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No malaria prophylaxis is 100% effective in prevention. Avoiding mosquito bites (i.e. using DEET, screens, and proper bed netting) when mosquitos are obviously present is important as well. If a person who has visited a malaria risk zone contract a fever within one year, their physician should be informed of the possibility of malaria. Note that lesser forms of malaria (such as P. vivax) can mimic the symptoms of the flu. Physicians who rarely, if ever, examine malaria patients may need to be reminded of this fact. The standard laboratory test for malaria is a thick and thin blood smear on a glass slide viewed under the microscope.

Related Topics:
Fever - Flu - Laboratory - Microscope

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Aspirin must never be taken as an antipyretic when malaria or dengue fever is a possibility. (Continuing daily low-dose 81 mg aspirin therapy during and after third-world travel should be discussed with your physician.) Acetaminophen and ibuprofen are considered safe alternatives provided all of their precautions are observed. Malaria, dengue fever, and typhoid fever all tend to have somewhat similar symptoms at first and should not be self-diagnosed.

Related Topics:
Aspirin - Antipyretic - Acetaminophen - Ibuprofen - Dengue fever - Typhoid fever

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