Malaria is an infectious disease caused by protozoan parasites that belong to the Plasmodium family. The infection is mosquito borne and affects both humans as well as other animals. The infection is spread to humans once the female anopheles mosquito carrying the parasite bites them. The parasite then enters the infected person’s liver where it multiplies and grows and then moves on to the bloodstream to affect red blood cells. This period between the mosquito bite and physical manifestation of symptoms is called the incubation period and it can range from 7 days to a year or more. In some cases, the parasite lies dormant in the liver for a few months to a year and becomes active at a later stage resulting in relapses.
Can You Prevent Malaria?
Currently, there is no vaccine to prevent malarial infection in adults. There is one vaccine called RTS,S that is currently approved to vaccinate young children, but it has a low efficacy rate. Research is still ongoing in this area to develop a vaccine for adults. Until that time comes, it is highly advisable that any individual traveling to a region where there is a high prevalence of malaria take the necessary precautions to avoid being infected by the malarial parasites.
There are mainly four recommended precautions, called the ABCD principles of malaria protection. The first principle is being aware about the disease, the second principle is to take steps to avoid being bitten by the mosquitos at night, the third principle would be to take prophylactic treatment before your travel and the fourth principle is to consult a physician within a week to a few months after the travel completion.
What is the Best Drug To Prevent Malaria?
There are mainly four medicines used for prophylaxis of malaria. These include chloroquine, mefloqine, doxycycline and a combination of atovone and proguanil. Most of these medications are also used in acute treatment of the disease. There is no one recommended drug for the treatment. Your preference on choosing any one-treatment option depends on a number of factors.
One factor could be your preference for the frequency of taking the medicine. Doxycycline and atovone/proguanial are taken daily versus mefloquin and chloroquine which are taken weekly.
Another factor is that some of these medicines need to taken at least a week or two before the travel date to be effect at achieving prophylaxis against malarial infection. Such as mefloquin needs to be started 2 weeks before departure while chloroquine just needs 1 week. In addition, most of these medications also need to be continued for a certain period of time after returning from the travel location to be effective at preventing malaria. Except for atovone/proguanil which need to be taken for 7 days post-return, the rest of the medicines need to be taken for 4 weeks post-return. This is because the malarial parasite has been known to be dormant from a few weeks to a year in the infected individual’s liver and so medication is important to prevent a future bout of the infection.
Your location of travel is also an important point of consideration. Certain medicines are more effective in certain geographies and less effective in others. Such as mefloquin is not very efficacious in certain regions of Southeast Asia.
In addition, certain pre-existing health conditions may contradict with a certain medication. Mefloquin should be avoided in patients with a history of anxiety and depression. Children younger than 8 years should not be given doxycycline as it is associated with discoloration of their teeth.
Therefore, there is no one best treatment option for the general population. It is advisable to talk to your physician before your travel date to discuss treatment options. Your physician can help you pick the best treatment option for you based on your preference, your travel location, the timing of your travel and your medical history.
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