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Heading to a region with malaria? Some simple steps to keep you safe

There are two type of medications used for malaria prophylaxis, they act at different life stages of the parasite in the body. Atovaquone-proguanil products stop infection early, soon after the mosquito bite. The second type (doxycycline, mefloquine and atovaquone-proguanil) treat a later stage of infection, but before the parasites can multiply enough to cause symptoms. Whichever medication your doctor recommends, if any, it’s important to take it exactly as directed and to finish the course. There’s a dangerous myth that chemoprophylaxis “masks” symptoms and makes malaria more difficult to diagnose. Prophylactic medications are highly effective if taken properly. But the infection may take…

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 Choosing a Drug to Prevent Malaria

Recommendations for drugs to prevent malaria differ by country of travel and can be found in CDC's Yellow Book chapter on Malaria Prevention Information, by Country. Recommended drugs for each country are listed in alphabetical order and have comparable efficacy in that country.

Articles of Interest

Chemoprophylaxis regimens: Canadian recommendations for the prevention and treatment of malaria

If several MCP are considered medically suitable for the patient, CATMAT suggests atovaquone-proguanil (AP) over mefloquine or doxycycline.

Drugs Used to Prevent Malaria

Preventive drugs are given orally...

Malaria Prevention, With Both Reward and Risk

With a limited lifetime, chemoprevention is not an ideal solution for malaria. But the situation is desperate. Malaria remains the No. 1 killer in several countries, and a vaccine that reliably and permanently prevents the disease may be more than a decade away from the market. In the meantime, some malaria parasites in Cambodia no longer respond to artemisinin, and the mosquitoes that spread the parasites are becoming resistant to the insecticides used to kill them. Despite its flaws, chemoprevention could prevent 8.8 million cases of malaria and 80,000 deaths annually — but right now, it lacks the political support to fund and carry it out to the full extent.

Malaria Prophylaxis: A Comprehensive Review

The importance of behavioural preventive measures (bed nets, repellents, etc.), adequate chemoprophylaxis and, in selected circumstances, stand-by emergency treatment may not be overemphasized. However, no prophylactic regimen may offer complete protection. Expert advice is needed to tailor prophylactic advice according to traveller (age, baseline clinical conditions, etc.) and travel (destination, season, etc.) characteristics in order to reduce malaria risk.

Malaria Protection for U.S. Travelers

To prevent malaria, the CDC recommends that travelers receive chemoprophylaxis. No antimalarial drug is 100% protective, and it must be combined with personal protective measures (insect repellent, long sleeves and pants, sleep setting that is mosquito-free or has an insecticide-treated bed net). The primary goal of malaria chemoprophylaxis is to prevent P falciparum infection, which is primarily responsible for malaria fatalities. The main antimalarial regimens are chloroquine, hydroxychloroquine, atovaquone-proguanil, doxycycline, mefloquine, primaquine, and tafenoquine. P falciparum resistance to chloroquine—and, to a lesser degree, other antimalarials—is a worldwide problem; chloroquine’s effectiveness is limited in most locations.

Malaria: Prevention, Diagnosis, and Treatment

All travelers to malaria-endemic regions should be prescribed prophylaxis. The choice of agent should be based on location and duration of travel, malarial resistance patterns, and the patient's medical history. All prevention regimens involve beginning the medication before departure, taking the medication while in the high-risk area, and continuing the medication for a defined period after travel has ended. The use of antimalarial agents does not negate the need for personal protective measures.

New Antimalaria Treatment Holds Promise As Prophylactic

A group of researchers led by Novartis AG have discovered novel malaria compounds that may prove to be more efficient than currently available treatments and could be used as a prophylactic to help further rein in one of the world's most dangerous illnesses.

Promoting malaria chemoprevention

WHO convened in 2021 a group of technical experts to review existing chemoprevention recommendations and ensure that these remain up-to-date and informed by the latest evidence. In line with the group's findings, WHO updated its recommendations for 3 key malaria prevention strategies: seasonal malaria chemoprevention (SMC), perennial malaria chemoprevention (PMC – previously known as intermittent preventive treatment in infants, or IPTi) and intermittent preventive treatment of malaria in pregnancy (IPTp). The new recommendations were published in the WHO guidelines for malaria in June 2022.

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StatPearls

Malarial chemoprophylaxis functions by targeting the liver schizont, blood schizont, or hypnozoite stages of the plasmodium life cycle. The three most commonly prescribed medications for chemoprophylaxis are atovaquone-proguanil, doxycycline, and mefloquine.