Updated
June 10, 2001

There are a number of drugs available that provide different levels of malaria protection

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Emergency Treatment

When locals get a bout of malaria they can go for an injection or pills, few Gambians can afford to take preventative pills.

If your visit is only 7 days long you are likely to be home before any Malaria symptoms show as incubation is at least 1 week. Go to your doctor if you get a hig fever and flu like symptoms.

For longer visits, and visits that include trips up river where you are more likely to get bitten we recommend that you take emergency precautions.

If you are close to a doctor seek proffessional advice.

If you are up river and suspect a malaria attack you can use a differnt pill to the one you are taking.

Daraprim - Pyrimethamine is readily and cheaply available from coastal chemists for about 50D for 30 tablets.

If you have been taking Larium or Chloroquine & Proquanil, adults should take 3 Daraprim tablets, 3 times daily for seven days

Children (5-10 years) 1.5 tablets, 3 times daily for 7 days.

Seek medical advice as soon as possible

Daraprim are so cheap - you might consider leaving any unused tablets with your GTS host, so they can be used to help locals who get a Malarial attack

THANK YOU

• The adult does is one tablet a day starting 24/48 hours before arrival
• Childs dose varies with weight
• then one tablet a day for7 days after leaving malarial zone

Side affects - are said by the manufacturer Glaxosmithkline to be milder than with other antimalarials.

Advertised costs (June 2001) are relatively high in the UK, 7 day holiday £28.65, 14 days £42.02, 21days £55.39 and 28 days £68.76

Mefloquine - brand name Lariam®

Directions for use:

• The adult dosage is 250 mg salt (one tablet).
• Take the first dose of mefloquine tablet 1 week before arrival in the malaria-risk area.
• Take mefloquine once a week while in the malaria-risk area.
• Take mefloquine once a week for 4 weeks after leaving the malaria-risk area.
• Mefloquine should be taken on a full stomach, for example, after dinner.

• Ever had an allergic reaction to mefloquine;
• Epilepsy or other seizure disorders;
• A history of severe mental illness or other psychiatric disorders;
• Been prescribed medication for an irregular heart beat.

Chloroquine + proquanil is a less effective alternative to mefloquine for travelers to Gambia.

Chloroquine - brand name Aralen®

Directions for use:

• The adult dosage is 500 mg (salt) chloroquine phosphate.
• Take the first dose of chloroquine 1 week before arrival in the malaria-risk area.
• Take chloroquine once a week while in the malaria-risk area.
• Take chloroquine once a week for 4 weeks after leaving the malaria-risk area. · Chloroquine should be taken on a full stomach to minimize nausea.

Chloroquine side effects

Although side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching can occur. Chloroquine may worsen the symptoms of psoriasis.

Pyrimethamine - Brand name Maloprim or Daraprim

Directions for use:

The adult dose is one tablet a week 25mg start one week befoe entering a mamaria risk area. Often taken with Chloroquine.

For children (5-10 years) half a tablet a week.

Side effects can be skin rash and i some East African areas resistance has been built up.

OR as emergency treatment if you were taking no preventative Malarial pills before the attack (see side bar)

Hydroxychloroquine sulfate - brand name Plaquenil®

Directions for use:

• The adult dosage is 400 mg (salt).
• Take the first dose of hydroxychloroquine sulfate 1 week before arrival in the malaria-risk area.
• Take hydroxychloroquine sulfate weekly while in the malaria-risk area.
• Take hydroxychloroquine sulfate weekly for 4 weeks after leaving the malaria-risk area.
• Take hydroxychloroquine sulfate on a full stomach, for example, after dinner, to minimize nausea.
• Hydroxychloroquine sulfate may be better tolerated than chloroquine.

Hydroxychloroquine sulfate side effects

Although side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching have been reported. Hydroxychloroquine sulfate may worsen the symptoms of psoriasis.

Alternatives to chloroquine and hydroxychloroquine sulfate: doxycycline, mefloquine, chloroquine + proguanil

Doxycycline

Directions for use:

• The adult dosage is 100 mg.
• Take the first dose of doxycycline 1 or 2 days before arrival in the malaria-risk area.
• Take doxycycline once a day while in the malaria-risk area.
• Take doxycycline once a day for 4 weeks after leaving the malaria-risk area.

Doxycycline side effects and warnings

• Taking doxycycline may cause travelers to sunburn faster than normal. To prevent sunburn, avoid midday sun, wear a high-SPF sunblock, wear long-sleeved shirts, long pants, and a hat.
• Take doxycycline on a full stomach to lessen nausea; do not lie down for 1 hour after taking the drug to prevent reflux (burping up stomach acid).
• Women who use doxycycline may develop a vaginal yeast infection. Take an over-the-counter yeast medication with you for use if vaginal itching or discharge develops.
• Do not give doxycycline to children under the age of 8; teeth may become permanently stained.
• Do NOT take doxycycline if you are pregnant.

Chloroquine + proguanil

• Is used for travelers to Africa who cannot take the more effective drugs mefloquine or doxycycline.
• Chloroquine + proguanil will provide some protection against malaria.
• Know that taking chloroquine + proguanil is a less effective combination than taking mefloquine or doxycycline and may put you at higher risk for malaria.
• Immediately see a health care provider if you develop fever or flu-like symptoms.
• Prevent mosquito bites to further reduce your risk of developing malaria.