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The information supplied
is derived from a number of reliable sources and is
compared and compiled into the alphabetical lists found
on this web site.
Countries requiring malaria prophylaxis should be
regarded as being at risk all year round and
you should also assume that the whole country
is at risk unless otherwise indicated. The malaria
regimen is the recommended regimen for a country.
Use of the incorrect regimen may not provide adequate
cover.
When there are two different regimens
for the same country, they are area specific. Read the
text to find out which regimen is suitable for the area
you require.
Where regimen 1 is indicated there is Chloroquine
resistance in that region and it is very likely to be
the Falciparum malaria which is the most serious form
of the disease. In this instance it is vitally important
that travellers take adequate prophylaxis.
Remember:- No prophylaxis is 100% effective but
not taking anti-malarials where they are indicated will
put you at greater risk should you get the disease.
Remember - Malaria is a killer!
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The Different Drug Regimens
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| Regimen
1 |
Mefloquine one 250mg tablet
weekly. OR
Doxycycline one 100mg capsule daily. OR
Malarone one tablet daily. |
| Regimen
2 |
Chloroquine 300mg
weekly (2x150mg tablets). PLUS
Proguanil 200mg daily (2x100mg tablets). |
| Regimen
3 |
Chloroquine 300mg
weekly (2x150mg tablets) OR
Proguanil 200mg daily (2x100mg tablets).
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| Regimen
4 |
No
prophylactic tablets required but anti mosquito measures
should be strictly observed: Avoid
mosquito bites by covering up with clothing such as long
sleeves and long trousers especially after sunset, using
insect repellents on exposed skin and, when necessary,
sleeping under a mosquito net. |
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| Proguanil
|
100mg tablets are
supplied as Paludrine Tablets |
| Chloroquine |
150mg tablets are
supplied as Nivaquine or Avloclor Tablets |
| Mefloquine
|
250mg tablets are
supplied as Lariam Tablets |
| Malarone |
is a
combination of Atovaquone 250mg and Proguanil
100mg |
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Length of Prophylaxis
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| Chloroquine, Proguanil & Maloprim |
Start
one week before travel, throughout your stay in
an endemic area and continue for four weeks after
return. |
| Mefloquine (Lariam) |
Start
two and a half weeks before travel, throughout
your stay in an endemic area and continue for four
weeks after return. |
| Doxycycline |
Start two days before travel, throughout
your stay in an endemic area and continue for four
weeks after return. |
| Malarone |
Start
two days before travel, throughout your stay in
an endemic area and continue for one week after
return. |
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IMPORTANT!
Take the
tablets absolutely regularly, preferably with or after
a meal.
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Long Term
Use of Anti-Malaria Drugs
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| Chloroquine |
May be
taken for periods exceeding five years. |
| Paludrine |
May be
taken for periods exceeding five years. |
| Maloprim |
Can be
taken for periods up to one year. |
| Mefloquine |
Can be
taken for periods up to one year. |
| Doxycycline |
Can be
taken for periods up to six months. |
| Malarone |
Can be
used for travel periods up to one year. |
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Compatibility of Anti-Malaria Drugs
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Pregnancy
|
Breast
Feeding
|
Epilepsy
|
Psoriasis
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Altitude
|
Scuba
Diving
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| Chloroquine |
OK
|
OK
|
NO
|
NO
|
OK
|
OK
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| Paludrine |
OK
|
OK
|
OK
|
OK
|
OK
|
OK
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| Mefloquine |
OK*
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NO
|
NO
|
OK
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NO
|
NO
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| Doxycycline |
NO
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NO
|
OK
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OK
|
OK
|
OK
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| Malarone |
NO
|
NO
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OK
|
OK
|
OK
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OK
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*
These drugs are not suitable during the first trimester
of pregnancy.
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Childrens' Dosages:
Calculate
the dose by weight rather than by age if possible
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Age/Weight
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Chloroquine
(once weekly)
|
Proguanil
(once daily)
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Mefloquine
(once weekly)
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Doxycycline
(once daily)
|
Malarone
(once daily)
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0
- 12 weeks
under 6kg
|
1/4
tablet
|
1/4
tablet
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-
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-
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-
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3
- 12 months
6 - 10kg
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1/2
tablet
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1/2
tablet
|
1/4
tablet
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-
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-
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1
- 3 years
10 - 16kg
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3/4
tablet
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3/4
tablet
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1/4
tablet
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-
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1
child's
tablet
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4
- 7 years
16 - 25kg
|
1
tablet
|
1
tablet
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1/2
tablet
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-
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1
child's
tablet
|
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8
- 12 years
25 - 45 Kg
|
11/2
tablets
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11/2
tablets
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3/4
tablet
|
-
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2
child's
tablets
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13
years and over
45kg and over
|
2
tablets
|
2
tablets
|
1
tablet
|
1
capsule
|
1
adult
tablet
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The
above dosages are based upon the guidelines issued by
the Advisory Committee on Malaria Prevention.
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Adult
Dosages
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Regimen
|
Dose
for
Chemoprophylaxis
|
Usual
amount
per tablet (mg)
|
| Areas
without drug resistance: |
|
Chloroquine
Proguanil
|
2
tablets weekly
2
tablets daily
|
150mg
(base)
100mg
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| Areas
of little chloroquine resistance (poorly effective where
marked resistance): |
Chloroquine
plus
Proguanil |
2
tablets weekly
2 tablets daily |
150mg
(base)
100mg |
| Areas
of chloroquine resistant P. falciparum: |
|
Mefloquine
Doxycycline
Malarone
(atovaquone & proguanil)
|
1
tablet weekly
1
tablet/capsule daily
1
tablet daily
|
250mg
(228 in USA)
100mg
250mg
atovaquone &
100mg proguanil
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Click
on the required region of the map below for a list of countries
in that region
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The
advice on malaria prophylaxis is primarily designed for short
visits (three months or less) to a particular region. The lists are
by no means exhaustive and are for quick reference purposes.
The
countries in the data tables are divided into their respective
continents.
Many
urban areas in otherwise malarious zones have little or no risk
e.g. Bangkok city is regarded as a no risk area but is surrounded
by rural areas of high risk.
Malarone
has recently become licensed in the UK for malaria prophylaxis
and is now recommended for use in those countries where Doxycycline
and Mefloquine are currently indicated. It is licensed for stays
of up to 28 days but can be used for stays of up to three months.
It should be started one or two days before departure and continued
for one week after return.
