Malaria Update

The American Academy of Family Physicians recently published an article about malaria prophylaxis for travelers (http://www.aafp.org/afp/2012/0515/p973.html), which is also accompanied by a patient handout on preventing malaria during travel (http://www.aafp.org/afp/2012/0515/p980.html).  It is important that travelers to sub-Saharan Africa, the Indian sub-continent and Southeast Asia, between the months of May to December, consider taking anti-malaria medication.  In many instances these medications need to be started prior to travel.  Given that there are approximatley 1 millions deaths worldwide every year from malaria, this is a big deal. 

Travelers to endemic areas should be aware of their potential exposure to malaria.  How is malaria tranmitted?  Mosquitos!  Mosquitos carry around those nasty little parasites that are the cause of malaria.  Five main species of parasites are responsible for transmission of malaria in humans: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium knowlesi, and Plasmodium malariae. These protozoa are concentrated in different areas of the world, and each produces a different manifestation of infection. P. falciparum is the most life-threatening form of malaria.
These parasites are transmitted to humans by the bite of an infective female Anopheles mosquito. To produce eggs, the mosquito usually consumes a blood meal, thus needing humans and animals as hosts.

What can you do to prevent acquiring malaria?  Insect repellant.  Some studies suggest that there is an 80% decrease in the incidence of acquring malaria just by using insect repellant.  If you plan to travel to endemic areas, don’t forget your DEET.

Concerned about the toxicity of DEET?  Consider using PMD instead.  Available since 2007, PMD is an extract from the eucalyptus plant. The formula is less toxic, cheaper, and more effective against malaria than a 20 percent solution of DEET.  In the United States, PMD is available as 65 percent and 10 percent concentrations.

What else can you do?  Take medication.  But you must start taking medication before travel, and then continue the medication during travel, and for a period of time after leaving the area where malaria is prevalent.  Atovaquone/proguanil (Malarone), doxycycline, and mefloquine are the drugs of choice for malaria prevention in most malaria-endemic regions.  These medications are easily obtained with a prescription from Rocky Mountain Urgent Care & Family Medicine.

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