31 Dec Malaria Prevention

We’ve had our travel injections and are almost set to hit the road, but there’s one disease we can’t be vaccinated against – Malaria.
Check out this update post to see how we’ve managed our malaria pills and medical vaccinations since we’ve been travelling.

Malaria Facts

According to the World Malaria Report, in 2010 there were 216 million cases of malaria worldwide and around 655,000 people died from the disease.

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So how is malaria spread? In certain parts of the world, particularly in Africa and Asia, mosquitoes are infected with malarial parasites. It only takes a single bite from one of these mosquitoes to infect you with this potentially-fatal disease.

Although malaria is treatable, if it’s not diagnosed quickly the disease can prove fatal. The World Health Organisation estimates that one child dies of malaria every 30 seconds in Africa. What makes malaria even more dangerous is that it can go unnoticed because its symptoms are very similar to that of a cold or flu; they include:

• Fever
• Vomiting
• Sweats and chills
• Headache
• Muscle pain
• Diarrhoea

Symptoms can appear as much as 15 days after you’ve been bitten and can lead to brain and neurological damage, epilepsy and in some cases, death. If you’ve travelled to a malarial country and experience any of these symptoms it’s important to see a doctor immediately, they can take a blood sample to determine whether you have the disease. In 2010, 1,700 travellers from the UK contracted malaria and seven of those cases proved fatal.

Malaria Hotspots

Malaria is present in more than 100 countries across Africa, Asia, South and Central America, the Middle East, the Pacific Islands and Haiti and the Dominican Republic. According to our travel itinerary, here are the countries in which we will be at risk from malaria:

• Indonesia – apart from major cities, malaria is prevalent across many parts of the country
• Philippines – there’s a high risk of contracting malaria in most parts of the country
• Thailand – is pretty low-risk now and tablets aren’t usually advised, unless you’re going to be staying around the country border
• Vietnam – malaria is prevalent throughout Vietnam
• Myanmar – there’s a high risk of contracting malaria across the country
• Laos – is a high risk malarial country
• Malaysia – parts of the country are high risk
• Cambodia – there’s a high risk of contracting malaria throughout

Malaria Prevention Advice

Unlike other diseases spread by mosquitoes, like Japanese Encephalitis, there’s currently no malaria vaccination. The best way of protecting yourself is to find out how to prevent malaria – here are some tips recommended by the UK travel advice centre:

• Use strong insect repellent containing DEET
• Cover up your arms and legs in at-risk areas, particularly at dusk when mosquitoes feed
• Use a mosquito net coated with insecticide
• Take the correct type of malaria pills, in the right dose for the necessary time period, depending on where you’re travelling to.

Do I need Malaria Tablets?

Taking malaria pills is really the best way to protect against contracting malaria; they might not provide 100 percent protection, but when combined with using repellent and covering up, they come pretty close.

Opinion is definitely divided on whether pills are effective, which type works best and whether they should be taken over long periods of time. I’m working on advice given by doctors in the UK and the government Fit for Travel website. Always ask a medical professional which type of malaria pills you need to take as this will vary depending on where you’re going; in some areas mosquitoes carry different strains of the disease or may have become resistant to particular types of medication.

As a rough guide though, here are some of the different types of malaria pills, the side effects, where they can be taken and example costs from Lloyds Pharmacy:

• Chloroquine
Dose: two tablets per week, to be taken one week before travel and for four weeks upon returning.
Cost: £1.98 for a 15-21 day trip
Possible side effects: nausea, diarrhoea, headache, rash, blurred vision, hair loss
Places on our itinerary that it can be used: Indonesia (when used together with Proguanil) except Lombok and Irian Jaya

• Atovaquone plus proguanil (Malarone)
Dose: one tablet per day, to be taken two days before travel and seven days upon returning.
Cost: £90 for a 15-21 day trip
Possible side effects: abdominal pain, headache, nausea, diarrhoea, coughing, mouth ulcers
Places on our itinerary that it can be used in: Philippines, borders of Thailand, Malaysia, Cambodia (except in western provinces), Laos, Vietnam and Myanmar

• Mefloquine
Dose: one tablet per week, to be taken two and a half weeks before you leave and for four weeks upon returning.
Cost: £42 for a 15-21 day trip
Possible side effects: nausea, diarrhoea, dizziness, abdominal pain, rashes, sleep disturbances, depression
Places on our itinerary that it can be used in: Indonesia (Lombok and Irian Jaya only), Philippines, borders of Thailand (except borders of Cambodia and Myanmar), Cambodia (except western provinces), Laos, Malaysia, Vietnam, Myanmar

• Doxycycline
Dose: one tablet per day, to be taken one week before travelling and for four weeks upon returning.
Cost: £40 for a 15-21 day trip
Possible side effects: sensitivity to sunlight, heartburn, diarrhoea, nausea, sore tongue
Places on our itinerary that it can be used: Indonesia (Lombok and Irian Jaya only), Philippines, borders of Thailand, Cambodia and Laos, Malaysia, Laos, Myanmar, Vietnam.

• Proguanil (Paludrine)
Dose: two tablets per day, to be taken one week before travelling and for four weeks upon returning.
Cost: £15.50 for a 15-21 day trip
Possible side effects: nausea, diarrhoea, mouth ulcers
Places on our itinerary that it can be used: Indonesia (when used together with Chloroquine) except Lombok and Irian Jaya.

Which type of Malaria pills do we need?

Since we’ll need malarial medication in lots of the countries on our travel itinerary and given the above prices, we could end up spending a fortune on malaria pills. So, we’ve decided to try and buy our tablets when we get to Indonesia. This might be a controversial choice; there have been stories of fake anti-malarial tablets being sold in Asia, but we’re going to make sure that we get ours from a reputable clinic.

What type of malaria pills do you use and have you ever bought any while you’ve been travelling?

*Sources: Fit for Travel, Lloyds Pharmacy, World Health Organisation, World Malaria Report. The above information serves as a guide only – always consult a doctor for comprehensive advice about malaria prevention.