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Malaria Prophylaxis

Malaria Prophylaxis

Are you planning an exciting adventure to a malaria-endemic region? Ensure you have the ultimate protection.  At Star Pharmacy, your well-being is our top priority, and we are dedicated to keeping you safe during your travels.

Malaria is a serious and potentially life-threatening disease transmitted by mosquitoes, and the risk varies depending on where you’re going. That’s why our personalised approach is essential in recommending the most effective malaria prophylaxis for you.

During your consultation, we’ll take into account your medical history, any current medications, and individual health factors to ensure you receive the most suitable and safe malaria tablets. Our goal is to equip you with the knowledge and resources you need to enjoy your trip worry-free.

Book an appointment to discuss which malaria tablet is suitable for you. Our experienced healthcare professionals will guide you through the process, tailoring their advice to your specific travel destination.

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Description

What is Malaria?

If you are planning a sunny, tropical trip abroad, please book an appointment with our trained pharmacist as you may require prophylaxis against malaria. There are many antimalarial drugs available, with the most common being malarone. These can be supplied by our trained pharmacist, under a patient group direction. 

Malaria is a tropical disease caused by the parasite Plasmodium. This parasite is spread to humans through the bites of infected mosquitoes. If you have signs and symptoms suggestive of malaria, it is vital that you get treated quickly. There are five types of malaria causing plasmodium parasites, and these include:

  • Plasmodium falciparum– is the most common type of parasite and is predominantly found in Africa.
  • Plasmodium vivax– produces milder symptoms when compared with plasmodium falciparum and is predominantly found in South America and Asia.
  • Plasmodium oval– is quite uncommon and is usually found in West Africa
  • Plasmodium malaria: very rare and is usually found in Africa
  • Plasmodium knowlesi- This parasite is only found in parts of South East Asia and is very rare.

If you are bitten by an infected mosquito, the malaria containing parasite will enter the bloodstream and eventually reach the liver. Once it reaches the liver an infection will begin to develop. This infection will now re-enter the bloodstream and begin to reproduce inside the red blood cells. Subsequently, the red blood cells will burst, releasing more parasites into the blood circulation. This bursting of red blood cells is what constitutes fever symptoms of malaria. Following the initial bite, it usually takes on average between 7-18 days for the sufferer to present with any symptoms. However it can take up to a year, so travellers should be careful of symptoms after returning from their trip.

What are the symptoms of malaria?

The initial symptoms of malaria are very similar to that of the flu and may include:

  • Fever
  • Sweating
  • Chills
  • Vomiting 
  • Headache
  • Diarrhoea
  • Muscle pains

If any of the symptoms of malaria develop, especially in the first three months of returning from a malaria high risk area, then see your GP immediately and ensure you inform them of your recent travel. 

How to diagnose Malaria?

If you are presenting with any signs or symptoms of malaria, or if you suspect you have it after having recently travelled to a high risk area, then please seek medical attention immediately. 

Malaria is usually diagnosed based on your recent travel history and your presenting symptoms. However, for a more definite and conclusive result a laboratory test using a microscopic analysis must be performed in order to demonstrate the presence of malaria parasites. An antigen test can also be a means of diagnosis if microscopic analysis is not feasible. This involves a finger-stick that samples a small quantity of blood. 

How to prevent Malaria?

Malaria can be prevented if the appropriate precautions are taken;; the ABCD is a good approach that can help minimise the risk of contracting the infection. 

  • Awareness of risk: Speak to a healthcare professional and/ or do research if your destination carries a risk of malaria
  • Bite Prevention: Mosquito bites can be avoided by using insect repellents, wearing long and loose clothing that covers the arms, legs and body and using mosquito nets.
  • Check if you need malaria chemoprophylaxis: If needed, ensure the correct medicine is taken, and to complete the course as directed.
  • Diagnosis: If you develop malaria symptoms, please seek medical attention immediately. Be extra vigilant if you develop symptoms up to a year after leaving the malaria zone.

What medicines are available to prevent malaria?

Taking antimalarial medication when travelling to a malaria high risk area is very important. It should be taken in conjunction with lifestyle measures to avoid bites. There are multiple regimens and options available depending on the country and area you are visiting and you should never assume that a tablet you have taken in the past is still appropriate, without liaising with a healthcare professional first. Please see below the different antimalarial medications available:

Atovaquone/ Proguanil

Both the ingredients: atovaquone and proguanil are anti-parasitic drugs which are active against the malaria-causing plasmodium parasite. Malaria is caused by the plasmodium parasite entering the bloodstream. Proguanil works by inhibiting the enzyme dihydrofolate reductase found inside the parasite, thus inhibiting its ability to reproduce. Atovaquone works in a similar way; it inhibits the formation of new genetic material from inside the malaria parasite, thus preventing the ability to reproduce. Together both atovaquone and proguanil work effectively together in preventing malaria. Plasmodium falciparum parasite is responsible for producing the most serious forms of malaria. For areas where this parasite is more dominant, atovaquone/ proguanil will be the recommended choice of prophylaxis.

Treatment details: Atovaquone/ Proguanil are now available as a generic alternative to the brand Malarone. Nonetheless, it is still produced to the same high standards and has the same efficacy as Malarone. It is however, available at a lower cost because the patent on the brand has now expired Prophylaxis should commence 24 or 48 hours prior to entering a malaria-endemic area, continue during the period of stay and continue for 7 days after leaving the area. The tablet should be taken daily, at the same time each day.

Doxycycline 100mg capsule 

Doxycycline is a broad spectrum tetracycline- class antibiotic that can be used in the treatment of infections caused by bacteria and certain parasites. Thus, it is used to treat acne, chlamydia, pneumonia, syphilis, cholera and is also used for the prevention of malaria. The malaria parasite is carried by mosquitoes and is passed onto humans through their saliva when they bite. Not all the parasites are the same, which is why choosing the correct treatment is imperative as one drug may be effective against one parasite but ineffective against another. When doxycycline is taken for the prophylaxis of malaria, it prevents the development of the parasite thus destroying it before it has got the chance to replicate and cause an infection. 

Prophylaxis should commence 1-2 days before travelling to a malarial area, during travel in the malarial areas and for 4 weeks after leaving the malarial area. Please book an appointment with our registered pharmacist if you would like a supply of doxycycline.

 Lariam 250mg tabs 

Lariam contains the active ingredient mefloquine hydrochloride. Malaria is caused by the plasmodium parasite. This parasite is carried by mosquitoes and transferred to humans through bites. Lariam works by interfering with the growth of the parasites in the red blood cells of the body. 

The dose of lariam tablets depends on your weight. Adults and children of more than 45kg in body weight should take one whole tablet each week, on the same day. The tablets should be swallowed whole preferably after a meal with plenty of liquid. In order to ensure that mefloquine is well tolerated before travelling, it is recommended that the patient should start prophylaxis 10 days before departure ( i.e. take the first dose 10 days before departure and the 2nd dose 3 days before departure). Treatment should therefore begin 10 days prior to travel, continue throughout the trip and to be continued for 4 weeks after leaving the malarious area. It is essential that you continue to take the tablets post-travel, to cover the disease’s incubation period. 

In addition to taking lariam tablets, you can further lower your risk of developing malaria by the following preventative measures:

  • Staying in air-conditioned rooms with screens on the window. If this is not possible then make sure the doors and windows are closed.
  • If there is no air conditioning at night, sleep under a mosquito net that has been sprayed with an insecticide. 
  • Use DEET or other insect repellents to protect your skin.
  • Wear light, loose fitting trousers and shirts with long sleeves. This is very important during the early evening and night when mosquitoes prefer to feed

Malarone 

Malarone is a branded medication and each tablet contains 100 mg proguanil hydrochloride and 250mg of atovaquone. Both are anti-parasitic drugs which are active against the malaria- causing plasmodium parasite. Malaria is caused by the plasmodium parasite entering the bloodstream. Proguanil works by inhibiting the enzyme dihydrofolate reductase found inside the parasite, thus inhibiting its ability to reproduce. Atovaquone works in a similar way; it inhibits the formation of new genetic material from inside the malaria parasite, thus preventing the ability to reproduce. Together both atovaquone and proguanil work effectively together in preventing malaria. 

Malarone is highly effective against malaria strains caused by the plasmodium falciparum parasite. This parasite is responsible for causing more severe symptoms of malaria. Malarone is also ideal for areas where there is a known resistance to other forms of antimalarial medicines.  

Prophylaxis should commence 24 or 48 hours prior to entering a malaria-endemic area, continue during the period of stay and continue for 7 days after leaving the area. The tablet should be taken daily, at the same time each day. 

Following a consultation, a supply of an antimalarial medication can be made by our experienced pharmacist, under a patient group direction based on your travel destination, medical history and current medication. If you do not meet the requirements, a supply cannot be made and an alternative can be suggested. 

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Malaria Prophylaxis

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