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Malaria prevention


Mosquito, courtesy of US Centers for Disease Control and Prevention, Wikipedia

Malaria is a disease which is passed to humans from the bite of an infected mosquito. It occurs in more than 100 tropical and sub-tropical countries around the world, including Kenya. The malaria parasite is carried in the saliva of certain mosquitoes and can be fatal to humans. If you are going on vacation to Kenya or planning an African safari, it is highly likely that you will visit a malaria-infected region. So it is vital you take the necessary precautions.

Many people buy over-the-counter medication, without first researching the disease or the malaria-infected area they intend to visit. This is a hazardous method, owing to the many strains of malaria and the unsuitability of certain anti-malarial products. In some regions, mosquitoes have developed a resistance to certain anti-malaria tablets (see Paludrine and Chloroquine below), rendering them ineffective, but a little research or expert advice would prevent the wrong product being administered.

Further complications may arise as a result of side effects, but this, too, can be avoided by consulting your doctor. Your medical history and current medication (if any) will be considered before prescribing any anti-malaria tablet, along with any possible adverse reactions, allergies, etc. It is, therefore, vitally important that you seek your GP's advice before choosing a suitable anti-malaria product.

Depending on the chosen course of malaria tablets, it is often necessary to start taking them a week or so before travel to the affected area, so don't leave research, or making an appointment with your doctor, until the last minute! Adhere strictly to dosages and schedules, as instructed, to avoid risk of infection. It is paramount that you continue the regimen, as prescribed, before and after your trip to cover the incubation period of the disease.


Types of malaria tablets available on the market:


Malarone:

Believed to be about 98% effective, Malarone is a combination of two drugs and should be started two days before travel.
Adult dosage: one tablet a day (taken with food or milk) and should be continued for one week after leaving the malaria-infected area.
Possible side effects: headache, abdominal pain, nausea, and vomiting.

Doxycycline:

More than 90% effective, Doxycycline is also used as an antibiotic. The first dose should be administered two days before travel to the malaria-infected area.
Adult dosage: one tablet a day (taken after food). The course should be continued for four weeks after leaving the area of risk.
Possible side effects: increased sun sensitivity, (avoid burning by using a high factor sunscreen) nausea and abdominal pain.

Larium:

More than 90% effective. The course should begin one week before arrival in the the malaria-infected area.
Adult dosage: one tablet on the same day each week (taken after food). Larium should be continued for four weeks after leaving the malaria-infected area.
Possible side effects: headache, dizziness, nausea, anxiety, difficulty sleeping, vivid dreams, and visual disturbances.

Paludrine and Chloroquine:

Read this article Telegraph buying malaria tablets at the chemist before considering using these drugs.
Paludrine and Chloroquine should be taken together, but in Africa, the malarial mosquito has built up such a resistance to these tablets, they are now less than 60% effective in most parts of the continent.



Malaria Prevention is Better Than Cure


No anti-malarial drug regime provides 100% protection, so prevention of mosquito bites is the key, even when taking a course of malaria tablets:


Protective clothing:

Mosquitoes are most active at night, dawn and dusk. Covering the skin during these hours - by wearing long trousers, socks and long-sleeved tops - will help prevent being bitten.

Mosquito Nets:

If you are not staying in an air-conditioned or well screened room then sleeping under a mosquito net that covers your bed is a very good idea. For added protection, have the net sprayed with insecticide, such as permethrin, which both repels and kills mosquitoes.

Mosquito coils and sprays will also help remove any mosquitoes that might be in the room before you sleep.

Mosquito Repellent:

Spraying your skin and clothes with mosquito repellent is an effective method of protection. Products which contain DEET offer the best protection. Re-apply according to instructions, for the product to remain effective. Higher concentrations of DEET may last longer but anything over 50% provides no added protection. Remember to apply the repellent to all areas of exposed skin, including face, ears, toes, fingers and ankles.

In the event of contracting malaria, or showing the following symptoms, seek medical advice immediately

Symptoms of Malaria:

Fever and flu-like illness, including head and muscle ache, shaking chills and tiredness. Nausea, vomiting, and diarrhoea may also occur. Malaria may cause anaemia and jaundice because of the loss of red blood cells. Infection of a particular type of malaria, P. Falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death.

Perhaps surprisingly, you are more likely to receive a swift and accurate diagnosis and treatment for malaria while in Kenya than once you return home. If you are showing any of the above symptoms, malaria is the first thing a Kenyan doctor will test for. Conversely, in developed countries with less experience of the disease, GPs are more likely to diagnose flu. So be sure to inform them of your travels to a malarious area - even if symptoms develop up to two years later.

Further details: Malaria Information Page - The Travel Doctor

NB: The information provided should not be used as a substitute for professional advice or for the diagnosis or treatment of any medical condition.


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