Malaria - Dr Livingstone's curse

The World Health Organisation (WHO) estimates that malaria kills over two million people on the planet every year.

There are four types of malaria, of which three are relatively less severe and easy to treat. Plasmodium falciparum is the one that causes most of the problems.

Malaria is a parasitic disease spread by the bite of the anopheles mosquito. The main symptoms are high fever, chills accompanied by sweating, headaches, and malaise. Symptoms usually occur after an incubation period, which can vary from 12 to 30 days.

There are two actions you can take to prevent contracting malaria: one take anti-malarial medication which is not always the healthiest or the most effective choice; two take adequate precautions to avoid being bitten.

Prevention with drugs
There are various anti-malarial drugs available on the market - none of which can claim to be 100% effective. If you decide to go with drugs, (assuming you are entering the jungle for a few days), you should choose the appropriate drug and dosage regimen suited to your destination and personal constitution and always tell your doctor of any other medical conditions or medication you are taking that could be affected by taking the anti-malarial drugs.

Dosage: One tablet once a week. One week before leaving, weekly while there, four weeks on return.
Side effects: Dizziness, unsteadiness, gastro-intestinal disturbances, headaches, depression and nightmares.
Marketed as Lariam, this drug is used alone in chloroquine resistant areas.

Dosage: Usually two tablets or capsules one a week. One week before leaving, weekly while there, four weeks on return.
Side effects: Upset stomach, dizziness, mouth ulcers.
Available as Daramal, Nivaquine, Plasmoquine or Anoclor. Used alone in chloroquine sensitive areas, or in combination with proguanil in chloroquine resistant areas.

Dosage: Two tablets per day. Not effective on its own, but used with chloroquine. Start the day before leaving, daily while there, and continue for four to six weeks on return.
Side effects: Mild stomach aches, mouth ulcers (rare).
Marketed as Paludrine. Not used in the US, but available in Europe, Canada, Australia and SA.

Avoid being bitten
As we have said no anti-malarial drug is 100% effective and many of the side effects can be quite worrying. The best way to prevent malaria is still to prevent the mozzies from biting you.
Here are a few tips:

  • Mosquitoes get active when the sun goes down. Wear long sleeves and pants from dusk onwards.
  • Use rub-on or spray repellent
  • Sleep under a mosquito net.
  • Burn mosquito coils
  • Use citronella soap or burn citronella oil. You may smell like a lemon, but you'll make a mosquito think twice.

© article from Bangkok General Hospital Group