Anti-Malaria Tablets

The risk of malaria is variable.  For some countries you may be advised to take scrupulous mosquito bite avoidance measures only; in other, higher risk areas mosquito bite avoidance measures will be advised toand in addition a course of anti malaria tablets will be recommended.

 There is a range of anti malaria drugs on the market; no one drug is effective everywhere. Malaria parasites may become resistant to anti malarial drugs. Choice of anti-malaria drug must be sought from a health care advisor who has access to up to date information of which drug is effective in the area you are planning to visit (this would usually be your doctor, practice nurse or pharmacist).

 Anti malaria tablets should always be taken according to the directions given to you by your health care advisor.  The time you start and finish your anti malarial drug is different for each type of drug.  Depending on the drug chosen, you will be instructed to start your anti malaria tablet(s) at a specified time between one to three weeks before you travel (this advice may be different if you are taking other medications and this should be discussed with your doctor, nurse or pharmacist).The instructions that you are given should be followed, otherwise the effectiveness of the tablets may be impaired, and it may be possible for Malaria to develop despite having taken the tablets.

If you have to travel at the ‘last minute’ you should still seek advice from an appropriately trained health care advisor about the risk of malaria and the options you have regarding malaria tablets.

 In addition to taking your tablets as directed (which includes finishing the course of tablets), strict mosquito bite avoidance measures should be taken as no anti malaria drug can be considered as 100% protective. 

Side effects from anti-malarial tablets may be a nuisance but are rarely dangerous. If side effects are a problem, it may be possible to swap to an alternative type of drug if there is adequate time prior to departure.  If side effects occur during your time in the malarial country, you should seek urgent medical advice regarding what to do. It is not always going to be possible to find totally side effect free prevention for every person, however the minor inconvenience of a drug side effect does have to be balanced against the risks and consequences of Malaria.

How to not get bitten.

All visitors to areas where malaria occurs areas should take scrupulous mosquito bite prevention measures, whether or not an anti malaria tablet has been advised http://www.nathnac.org/travel/misc/travellers_mos.htm 

 Have you ever tried sitting outside on a warm buggy summer night in the West of Scotland and not getting midge bites? If you can pull this trick off then avoiding Malaria should cause you no problems.

However for the rest of us.........Read on.:

Mosquitos mainly bite at dusk and at night. To avoid being bitten at night a mosquito net properly fitted over the bed is essential. Preferably one impregnated with Permethrin.

Try to avoid sitting outside at dusk and at night. If this is unavoidable then have as little exposed skin as possible. Wear trousers not shorts and a long sleeved shirt. Smother all exposed bits in an effective insect repellant (30% DEET).  Pregnant women, children (who cannot avoid travel) and those with serious skin conditions should seek additional advise from their doctor, nurse or pharmacist..

This may not sound like a whole lot of fun in a tropical climate, however you do what you can to lessen your risk.

What If I can't or don't want to take a tablet?

The consequences of not taking Malaria tablets and quite possible catching Malaria vary according to the type of Malaria prevalent where you are going. All malaria is a serious problem, however falciparum or cerebral Malaria is a life threatening condition. People can and do die from cerebral Malaria even after they get home to a modern intensive care unit. Unfortunately falciparum Malaria is one of the commonest forms, particularly in many of the most popular tourist areas.

Catching Malaria can be easier than expected. As visitors from Northern Europe we have zero immunity to the parasites, and can be highly susceptible to infection from the small number of parasites that even a few bites can transmit, especially children, pregnant women and those with certain medical conditions.

Some people are genuinely not able to tolerate the side effects and can simply not take the pills. Others are unhappy about taking any drug especially if they may see it as non-essential. Whilst this point of view is quite understandable, to consider ati-malaria treatment as non-essential is possibly missing an important point. To travel to a high-risk destination for malaria, without taking appropriate anti malarial treatment is strongly discouraged ifor any person. They would be putting themself at needless risk of a serious or life-threatening illness.  Children, pregnant women and those with particular medical conditions (e.g. without a spleen or a poorly functioning spleen) are particularly vulnerable.

It may be that you could be advised that if you can not or will not take an anti malarial drug then you should not travel to your intended destination. This may seem excessive

One word of warning. Tour companies and travel insurers do not accept inability to take Malaria tablets as a legitimate reason for refunding your cash if you do have to cancel for this reason. They expect you to find out about this sort of thing before you book and pay.