What is Malaria?
Malaria is a mosquito-borne parasite which is present in many parts of the tropics. The illness results in approximately 400,000 to 600,000 deaths annually. Sadly, most of the lives lost are children. Of the six species of plasmodium parasite causing human malaria the vast majority of severe illness results from one species, Plasmodium falciparum.
FAQs
Is there malaria at my destination?
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Malaria is common throughout the tropics. You'll find a complete list of the types of malaria present in your destination country at the CDC website. This site also outlines which parts of the country are affected.
Which type of anti-malarial prophylaxis is best for me?
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Available antimalarials include doxycycline, mefloquine, atovaquone-proguanil, tafenoquine and chloroquine. The options for your destination will depend on the types of resistance present. Chloroquine resistance, for example, is widespread in many areas, so this is an option only for some countries in Central America and the Caribbean.
If you have no underlying health conditions and are not pregnant, then the choice between agents comes down to side effect profile, duration the tablets need to be taken and cost. For more information, see our blog 'Do I need to take anti-malarial tablets on my overseas trip?'. Your travel doctor will be able to recommend the right tablets for you.
How much do anti-malarial tablets cost?
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The cost varies, depending on the type of anti-malarial tablet. Doxycycline is around $30 to $40 for a three to four week trip. Atovaquone-proguanil is more expensive, at around $60 to $120 for a two week trip.
Can I get malaria while taking anti-malarial tablets?
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While anti-malarial tablets are highly effective, they are not one hundred percent effective. If you develop symptoms of malaria, like fever, headache and muscle aches, while in a malarious area or within four weeks of your return, you need to seek immediate medical attention.
What to Know
Malaria symptoms
After the bite of an infectious mosquito, malaria parasites move to the liver and later infect circulating red blood cells. Symptoms begin after an incubation period of between 7 and 35 days and include fever, chills, fatigue, headache, loss of appetite and nausea. In the context of infection with Plasmodium falciparum, rapidly life-threatening complications such as brain infection and severe anaemia can then develop.
Malaria diagnosis and treatment
Malaria diagnosis can be made by looking at a smear of a patient’s red blood cells under a microscope to find the characteristic forms of the various species of malaria parasite. PCR testing is also used. In remote areas, the diagnosis can more conveniently be made using finger prick blood tests which use a similar principle to the rapid antigen tests used for COVID-19. Treatment for malaria involves anti-parasitic medications with admission to hospital for severe cases.
Malaria prevention
For travellers to malarious areas in the tropics, prevention involves mosquito avoidance and prophylactic anti-malarial tablets.
The vector which carries the parasite is the female Anopheles mosquito. These mosquitoes feed between dusk and dawn. They are generally more numerous during the rainy season. Strategies for mosquito avoidance include sleeping in air-conditioned rooms or spaces with fly screens (and where this is not possible, under permethrin treated mosquito nets), wearing long sleeves and long pants when outside, and using insecticides containing DEET, picaridin or oil of lemon eucalyptus.
Anti-malarial tablets need to be started before arrival in the malaria-prone area and continued for one to four weeks after leaving, depending on the agent used.
Those who have grown up in an area where malaria is present develop a degree of immunity due to recurrent exposure to the parasite. However, on moving out of the malarious area, this partial immunity is lost after only a few months and they are once again susceptible to severe and life-threatening infection. So preventive measures, including anti-malarial tablets are still recommended.