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Malaria Treatments: Vaccine & Prophylaxis

Instructor: Ian Lord

Ian has an MBA and is a real estate investor, former health professions educator, and Air Force veteran.

Malaria is a debilitating mosquito-borne illness, but it can be prevented. In this lesson we will identify and describe the preventative treatments of malaria.

Malaria Preventative Treatment

Nancy is a contractor getting ready to go overseas and has been told she needs to take medication because of the prevalence of malaria in the area she will be working. She has never had malaria before, and wonders why she needs medicine now. Malaria is a potentially fatal disease transmitted by infected mosquito bites that can cause fever, fatigue, vomiting, and headaches. Preventative treatment with medications, or prophylaxis, will help keep Nancy from getting sick. Let's discuss how prophylaxis can serve as an effective preventative treatment of malaria.

Prophylaxis

Prophylaxis in this context refers to having Nancy take medication so that she doesn't get sick in the first place, and it is essential because there is currently no effective vaccine for malaria. The medication side effects and the cost of treatment are far less than the risks of having to be treated after getting sick. Although no antimalarial medication is 100% effective, when combined with mosquito bite protection measures such as long-sleeved clothing, netting, and repellent the odds of infection can be significantly reduced. There are ongoing attempts to develop vaccines in clinical trials, but so far the results have not demonstrated enough resistance to the disease.

A number of medications are available. Exactly which medication (or even a combination of several) will depend on what countries Nancy will be in, her personal preferences, and her medical history. Different medications also have varying guidelines in terms of how often doses need to be taken and how long before or after the trip medication is necessary. Let's look at several medications commonly used to prevent malaria.

Atovaquone/Proguanil

This medication also goes by the brand name Malarone and is suitable for short trips. Nancy could start taking this medication one to two days before her trip and continue to take the pill daily until one week after the trip. There are very few side effects, but the medication cannot be taken if she is pregnant or has kidney disease. It is also one of the more expensive options.

Chloroquine

The advantage of chloroquine is that it can be taken once a week. Unfortunately for Nancy, she would have to start taking it one to two weeks before the trip and continue to take it for a month after her return. Chloroquine is safe for pregnant women. In many parts of the world, this medication is not an option because the disease has developed a drug resistance and is no longer effective.

Doxycycline

Doxycycline, also commonly called doxy, is an inexpensive medication that can be started a day or two prior to travel to a malaria zone. However, it requires four weeks of continued daily doses after return. Doxy is a wonderful multitasker; it can help prevent other infections common in developing countries and even treat chronic acne. Some patients complain of an upset stomach and increased sun sensitivity, and it is not safe for pregnant women and young children.

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