malaria

• malaria?

  symptoms can appear 10-15 days after the infective mosquito bite.

  dosage regimen can vary geographical location
• malaria prophylaxis refer?

  • anybody falling ill/malaria symptoms (severe flu, fever, headache, sweating, chills & vomitting within 1 year and especially within 3 months after coming back from a malarial region, despite having followed all precautions.
• malaria prophylaxis counselling?

  • prevention is key as treatment is not 100% effective
  • using insect repellent (containing DEET) provides longer protection
  • DEET containing products can be used in children >2 months and in pregnant/breastfeeding
  • DEET reduces the SPF of sunscreen, therefore always apply DEET after sunscreen (SPF 30-50 is best)
  • long sleeves & trousers worn after dusk provide protection against bites
  • use of mosquito bed nets, especially those impregnated with repellent e.g. permethrin
• what medicines are used in malaria prophylaxis?

  • proguanil 100mg tablet (paludrine)
  • chloroquine phosphate 250mg tablet (avlocolor, equivalent to 155mg of chloroquine base)
  • atovaquone/proguanil 250mg/100mg (maloff protect)
  • doxycycline POM
• proguanil 100mg tablet (paludrine) ?


  • daily dose
  • start 1 week before entering malarial region (urgent cases can start 2 days before)
  • continue for 4 weeks after leaving the region
  • caution; renal impairment REFER TO GP
  • side effects: megaloblastic anaemia, skin rash, diarrhoea/GI upset
• chloroquine phosphate 250mg tablet (avlocolor, equivalent to 155mg of chloroquine base)?

  • weekly dose
  • start 1 week before entering malarial region
  • continue during stay
  • continue for 4 weeks after leaving the region
  • NOT for amiodarone patients
  • side effects agranulocytosis/ blood disorders, hypoglycaemia, depression
• • atovaquone/proguanil 250mg/100mg (maloff protect)?
  • daily dose
  • start 1-2 days before entering malarial region
  • continue during stay
  • continue for 1 week after leaving the region
  • licensed for adults only
  • NOT for <40kg
  • MAX 12 week supply, longer duration is PGD or POM
  • refer planning to conceive/pregnant/breastfeeding
  • side effects: headache, nausea, vomiting, depression
  • NOT for warfarin, rifampicin, antiretroviral patients (also prolongs QT interval)
• • doxycycline
  • start 1-2 days before entering malarial region, during stay, 4 weeks after leaving