Malaria prevention is top of the list for anyone intending to visit a part of the world where malaria mosquitoes are to be found. Personal protection for the traveller focuses on two main aspects, the first is to prevent being bitten by mosquitoes and the second relies on taking antimalarial drugs regularly.
When a malaria-carrying mosquito bites a person, the malaria parasites travel to the liver via the blood stream and develop there without causing any signs of illness. Once the parasite is ready, it leaves the liver and attacks the red blood cells. This is the stage at which anti-malarial drugs act, by preventing the parasite from infecting blood cells and thereby preventing the symptoms of malaria from developing. It is important to keep taking anti malarial regularly while abroad, so that drug levels in the blood are sufficient to prevent disease, and to continue taking the drugs for four weeks after leaving the malaria area, so that the incubation period after any potential bites is covered by the drugs.
The malaria-carrying mosquitoes bite from dusk to dawn and bites can be prevented by using a combination of methods:
The first is your clothing and the recommendation is you wear shirts and trousers after dusk. Clothing can also be soaked in repellent, 30 millilitres of repellent dissolved in 250 millilitres of water is an effective mixture, or sprayed with 100 per cent DEET but you must use only on cotton not synthetic clothes.
Secondly is the use of barriers, and you must if you can sleep in an air-conditioned or a screened room, or under a mosquito net preferably one impregnated with perme-thrin, in the ratio of 0.2 grams of permethrin per metre of material. A small but very valid point is to ensure the net is complete with no tears, and especially if you are in non airconditioning, that you ensure the net is empty after you get in, and sealed by tucking into the mattress.
Thirdly repel or kill any mosquitoes which have entered the bedroom klamboe with pyrethrum sprays, mosquito coils or electrical insecticide dispensers. Electronic buzzers are not effective. Using repellents containing diethyltoluamide, DEET, 50 per cent DEET is more effective, and recommended for malaria areas. Children, pregnant women and travellers with skin conditions may prefer to use eucalyptus-based repellent Mosiguard Natural.
Anti-malarial drug therapy is an area fraught with difficulty. The changing pattern of drug resistance, together with possible side-effects of the drugs, have made it increasingly difficult to choose the correct regimens. With this in mind, it is advisable for all travellers to obtain specialist advice prior to their trip.