Malaria prophylaxis is a method used to prevent malaria, an infectious disease transmitted by mosquitoes. There are many prophylaxis—meaning prevention—drugs available to thwart malaria infections. People should consider where they are traveling, how often they are willing to take the drugs and any preexisting conditions that may make one medication better than another. It is also important to think about how soon before travel to start malaria prophylaxis and how much one is willing to spend on prevention methods. For people unwilling or unable to take drugs, there are alternative options, such as bed nets, available.
Common drug malaria prophylaxis options include atovaquone, chloroquine, doxycycline, mefloquine and primaquine. It may be helpful to choose a medication based on travel plans. For instance, primaquine targets P. vivax, a specific type of malaria that is common in southeast Asia. Some prophylaxes may be useless in certain countries because of drug resistance. Angola and Afghanistan have verified chloroquine resistance, for example.
Malaria prophylaxis choice also should be based on the length of the trip and how often the traveler is willing to take the drug. Atovaquone, doxycycline and primaquine are taken daily—some prefer the ritual or are not bothered by a daily medication on a short trip. Chloroquine and mefloquine are taken weekly; this may make the antimalarial drugs better for longer trips or for people do not wish to take daily malaria tablets.
Preexisting health conditions also should guide malaria prophylaxis choice. Chloroquine can worsen psoriasis, while doxycycline exacerbates yeast infections, for instance. Likewise, mefloquine is not recommended for people with a personal or family history of psychiatric disorders. Several of the drugs also are unsuitable for pregnant or breastfeeding women. It is best to research the individual malaria prophylaxes to learn which options are not recommended based on personal health history.
Certain malaria prophylaxis drugs, such as chloroquine, must be started well before travel begins in order to take effect. Others, including primaquine and atovaquone are better options for last-minute travelers. These medication courses may be started just days before entering a malarial zone.
Do not forget to factor in cost in the final malaria prophylaxis choice. Weekly drugs tend to cost more than the daily options; the trip length, however, will dictate the overall cost. Research whether or not the preferred medication is available in the country visited—sometimes, it is cheaper to buy drugs for malaria outside of the United States, for example.
No malaria prophylaxis provides guaranteed prevention. Medical professionals recommend pairing the drugs with other methods, including sleeping under bed nets, using insect repellent and wearing long sleeves and pants. Some people may prefer these non-drug prevention methods over medication. Discussing options with a travel physician can help in deciding which malaria prevention plan is best based on individual circumstances.