Prevention of Malaria
Prevention list: Methods of prevention of Malaria mentioned in various sources includes those listed below. This prevention information is gathered from various sources, and may be inaccurate or incomplete. None of these methods guarantee prevention of Malaria.
- Antimalarial drugs - e.g. chloroquine or hydroxychloroquine sulfate
- Avoid mosquito bites
- Mosquito repellants
- Sleeping under bednets
- Stay indoors at dusk and nighttime
- Malaria vaccine (under development) - a vaccine has been difficult to develop.
- See also prevention of mosquito bites
- See also prevention of mosquito-borne diseases
Prevention of Malaria: Drugs to prevent malaria, called antimalarials, are available only by prescription through a health care provider. Your health care provider will prescribe your child's antimalarial based on the travel itinerary and medical history. Some antimalarial drugs are more effective in some parts of the world than others. In addition, a medical condition may prevent your child from taking certain drugs. Alternative drugs are available and are discussed below.
Antimalarial Warnings and Instructions
- Overdosage of antimalarials can be fatal. Keep drugs in childproof containers out of the reach of children.
- Give antimalarials to children exactly on schedule without missing doses.
- For young children who cannot swallow tablets, have their prescription filled at a full-service pharmacy. Your pharmacist will need to make a special drug preparation for your child to take. The pharmacist should grind the tablet, weigh each dose, and store the powder in a gelatin capsule. Plan ahead; it will likely take 34 days for the prescription to be filled.
- Mefloquine, chloroquine, and Malarone taste very bitter. To give your child the medicine, break open the gelatin capsule and mix the drug with something sweet, such as applesauce, chocolate syrup, or jelly.
- Buy antimalarials in the United States before travel overseas. The quality of antimalarials sold outside of the United States may not be reliable.
Find Out Which Drug Is Recommended for Your Child
Your child will be prescribed one of the following antimalarials. Find the drug below; read the directions for use and side effects. If you have questions about the drug recommended for your child, call your child's health care provider or pharmacist.
- Children traveling to malaria-risk areas in South America, Africa, the Indian subcontinent, Asia, and the South Pacific should take one of the following drugs: mefloquine, doxycycline, or Malarone.
Directions for use
- Your child's health care provider will prescribe mefloquine based on your child's weight.
- Give the first dose of mefloquine 1 week before arrival in the malaria-risk area.
- Give mefloquine once a week, on the same day of the week, while in the malaria-risk area.
- Give mefloquine once a week for 4 weeks after leaving the malaria-risk area.
- Mefloquine should be taken on a full stomach, for example, after dinner.
Mefloquine side effects
Most children who take mefloquine have few, if any, side effects. The most common side effects in children are nausea and vomiting. These usually do not require stopping the drug. If your child vomits the drug within 30 minutes, give the child another dose of the drug (mix with something sweet, like pudding or applesauce). If he or she vomits after 30 minutes, enough of the drug has been absorbed and you do not have to give a second dose. Mefloquine very rarely causes serious side effects such as seizures. Children who have serious side effects should be taken to a health care provider.
Children should NOT take mefloquine if they have
- Ever had an allergic reaction to mefloquine;
- Epilepsy or other seizure disorders;
- A severe psychiatric disorder;
- Been diagnosed or treated for an irregular heartbeat.
- Alternative drugs for children who cannot take mefloquine include doxycycline or Malarone.
Directions for use
- Your child's health care provider will prescribe doxycycline based on your child's weight.
- Give the first dose of doxycycline 1 or 2 days before arrival in the malaria-risk area.
- Give doxycycline once a day, at the same time each day, while in the malaria-risk area.
- Give doxycycline once a day for 4 weeks after leaving the malaria-risk area.
Doxycycline side effects and warnings
- Do not give to children under the age of 8; teeth may become permanently stained.
- Taking doxycycline may cause children to sunburn faster than normal. To prevent sunburn, have your children avoid midday sun, wear a high-SPF sunblock, wear long-sleeved shirts, long pants, and a hat.
- Give children doxycycline on a full stomach to lessen nausea; children should not lie down for 1 hour to prevent reflux (burping up stomach acid).
- Alternative drugs for children who cannot take doxycycline include mefloquine or Malarone.
Directions for use
- Your child's health care provider will prescribe Malarone based on your child's weight.
- Give the first dose of Malarone 1 or 2 days before travel to the malaria-risk area.
- Give Malarone once a day in the malaria-risk area.
- Give Malarone once a day for 7 days after leaving the malaria-risk area.
- Give the dose at the same time each day with food or milk.
Malarone Side Effects and Warnings
Although side effects are rare, abdominal pain, nausea, vomiting, and headache can occur. Malarone should not be taken by infants weighing less than 11 kg (24 lbs). Malarone should not be taken by patients with severe renal impairment.
- Children traveling to malaria-risk areas in Mexico, Haiti, the Dominican Republic and certain countries in Central America, the Middle East, and Eastern Europe should take either chloroquine or hydroxychloroquine sulfate as their antimalarial drug.
Chloroquine/ brand name Aralen®*
Directions for use
- Your child's health care provider will prescribe chloroquine based on your child's weight.
- Give the first dose of chloroquine 1 week before arrival in the malaria-risk area.
- Give chloroquine once a week, on the same day each week, while in the malaria-risk area.
- Give chloroquine once a week for 4 weeks after leaving the malaria-risk area.
- Chloroquine should be taken on a full stomach, for example, after dinner, to lessen nausea.
Chloroquine side effects
Although side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching have been reported. Chloroquine may worsen the symptoms of psoriasis.
- Chloroquine is sold in the United States in tablet form only.
- In foreign countries, drug companies sell chloroquine as a syrup. Parents should consult the local pharmacist for the correct dosage of chloroquine.
Hydroxychloroquine sulfate/ brand name Plaquenil®*
Directions for use
- Your child's health care provider will prescribe hydroxychloroquine sulfate based on your child's weight.
- Give the first dose of hydroxychloroquine sulfate 1 week before arrival in the malaria-risk area.
- Give hydroxychloroquine sulfate once a week, on the same day each week, while in the malaria-risk area.
- Give hydroxychloroquine sulfate once a week for 4 weeks after leaving the malaria-risk area.
- Take hydroxychloroquine sulfate on a full stomach, for example, after dinner, to minimize nausea.
- Hydroxychloroquine sulfate may be better tolerated than chloroquine.
Hydroxychloroquine sulfate side effects
Although side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching have been reported. Hydroxychloroquine sulfate may worsen the symptoms of psoriasis.
Prevent Insect Bites
Protect your child from mosquito bites. Have him or her wear long-sleeved shirts and long pants; apply insect repellent to exposed skin. Mosquitoes that transmit malaria bite between dusk and dawn. Use insect repellents that contain DEET.
When using repellent with DEET, follow these precautions
- Always use according to label directions.
- Use only when outdoors and wash skin after coming indoors.
- Do not breathe in, swallow, or get into the eyes.
- Do not put on wounds or broken skin.
- The concentration of DEET varies among repellents. Repellents with DEET concentrations of 30% to 35% are quite effective, and the effect should last about 4 hours.
Travelers who will not be staying in well-screened or air-conditioned rooms should use a pyrethroid-containing flying-insect spray in living and sleeping areas during evening and nighttime hours. In addition, travelers should take additional precautions, including sleeping under mosquito netting (bed nets). Bed nets sprayed with the insecticide permethrin are more effective. In the United States, permethrin is available as a spray or liquid to treat clothes and bed nets. Bed nets may be purchased that have already been treated with permethrin. Permethrin or another insecticide, deltamethrin, may be purchased overseas to treat nets and clothes.1
Malaria can often be prevented by the use of antimalarial
drugs and the use of personal protection measures against mosquito bites.
Anopheles mosquitoes bite during nighttime hours, from dusk to
dawn. The risk of malaria depends on the traveler's itinerary, the
duration of travel, and the place where the traveler will spend evenings
and nights. 2
1. excerpt from Preventing Malaria in Infants and Children: DPD
2. excerpt from Facts About Transfusion-Transmitted Malaria: CDC-OC
Last revision: June 2, 2003
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