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Malaria - prevention Q&As

Published by Bupa's health information team, November 2008.

Answers to questions about malaria - prevention

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Should children take antimalarial medicines too?

Yes, children should be given antimalarial medicines if you're taking them to a malaria risk area. Ask your GP for advice on which medicines are suitable for your child to take. If possible, it's best not to take babies or very young children to an area where they will be at high risk of getting malaria.

Explanation

Children are particularly susceptible to malaria, so they need to be given antimalarial medication. However, not all antimalarial medicines are suitable for children to take. Chloroquine and proguanil are both antimalarial medicines that are suitable for children and can be given to children of any age. Chloroquine can be given to your child as a syrup, but proguanil will need to be crushed and given with food.

Other medicines can be given to children as they get older but this will depend on how much they weigh. Doxycycline shouldn't be given to children under the age of 12. Your GP can advise you on which antimalarial medicines are suitable for your child to take.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine. Antimalarial medicines should be kept in a child-proof container and out of the reach of children.

Further information

Sources

  • International travel and health. World Health Organization. www.who.int, accessed 14 August 2008
  • Malaria prophylaxis. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 14 August 2008
  • Frequently asked questions on malaria prevention. Health Protection Agency. www.hpa.org.uk, accessed 14 August 2008
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Can malaria become resistant to antimalarial medicines?

Yes, some of the parasites which cause malaria have become resistant to certain antimalarial medicines, and this can be a serious problem.

Explanation

The Plasmodium parasites that transmit malaria can become resistant to certain antimalarial medicines. This means that the parasite can survive within your body even if you take a full course of antimalarial medicines.

Resistance to antimalarial medicines has spread very quickly over recent years. At least two of the four species of malaria parasite have now become resistant to some types of antimalarial medicine. The parasite P. falciparum, which causes the most severe form of malaria, has become resistant to nearly all antimalarial medicines.

Whether or not there are any medicine-resistant mosquitoes present will depend on where in the world you're travelling to. So the antimalarial medicine that your GP recommends will depend on where you're going.

Further information

Sources

  • Beers MH, Fletcher AJ, Porter R, et al. The MERCK manual of medical information. 2nd ed. New York: Pocket Books, 2003: 1140-1141
  • medicine resistance in malaria. World Health Organization. www.who.int, accessed 18 August 2008
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What strength of diethyltoluamide (DEET) insect repellent should I use, and can other types of repellent be as effective?

You should use an insect repellent containing DEET at a concentration of at least 20 percent. If you're allergic to DEET there are some alternative repellents that you can use.

Explanation

Using an insect repellent that contains DEET is the most effective way of reducing the risk of getting bitten by mosquitoes. You can apply insect repellent to your skin as either a lotion, spray or roll on.

You can buy insect repellents containing a range of different concentrations of DEET. You should use one with a concentration of at least 20 percent. An insect repellent containing 20 percent DEET will provide protection against mosquitoes for between one and three hours. Repellents with higher DEET concentrations provide protection for longer and 50 percent DEET will protect you for up to 12 hours. It isn't necessary to use a repellent with a DEET concentration of over 50 percent as it won't provide you with any extra protection.

It's a good idea to use a repellent containing 50 percent DEET as this provides protection for the longest amount of time, meaning that you won't need to re-apply it very often. Lower concentrations aren't suitable if you're going to be exposed to mosquitoes for long periods of time, such as if you're backpacking.

Repellents with concentrations of up to 50 percent DEET are safe for pregnant women to use. Insect repellents containing DEET shouldn't be used for babies under two months old.

If you're allergic to DEET, you should use either lemon eucalyptus, picaridin or 3-ethylaminopropionate. Lemon eucalyptus will provide you with the same amount of protection as a repellent containing 15 percent DEET. Picaridin is a newer type of repellent which is just as effective as repellents containing DEET. If you choose to use picaridin then you should use a repellent with a concentration of 20 percent. 3-ethylaminopropionate provides a shorter duration of protection than DEET so will need to be applied more often. Your GP can advise you on which repellent would be the most suitable for you to use.

Oil of citronella based products do provide some protection against mosquito bites, but only for a short period of time so you shouldn't use these for protection. You shouldn't use herbal or homeopathic remedies either as there is no scientific evidence that these will prevent mosquitoes from biting you. The following things aren't recommended for repelling mosquitoes: electronic buzzers, vitamin B1, garlic, yeast spreads such as Marmite, tea tree oil and bath oils. There is little evidence that these measures are effective.

Further information

Sources

  • Malaria prophylaxis. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 14 August 2008
  • Guidelines for malaria prevention in travellers from the United Kingdom - bite prevention. Health Protection Agency. www.hpa.org.uk, accessed 19 August 2008
  • Malaria: prevention in travellers. BMJ Clinical Evidence. www.clinicalevidence.com, accessed 19 August 2008
  • Joint Formulary Committee, British National Formulary. 55th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008: 344-347
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Can I buy my antimalarial medicines once I get to the country I will be travelling in?

No, you should get your antimalarial medicines from a pharmacy in the UK before you travel.

Explanation

If you buy antimalarial medicines in the country that you will be travelling in there is a risk that they could be fake. You should make sure that you have all the medication you will need with you before you travel. You will need to start taking your antimalarial medicines before you travel so you should visit your GP early enough to allow time for this. If you're going to be abroad for a long period of time or have existing medical conditions such as renal failure you will probably need expert advice. You should visit a travel clinic before you leave the UK.

You should get your medication from a pharmacy in the UK. You shouldn't buy it over the internet. Visit your GP or a travel clinic for advice on which antimalarial medicines you should take.

Further information

Sources

  • Guidelines for malaria prevention in travellers from the United Kingdom - chemoprophylaxis. Health Protection Agency. www.hpa.org.uk, accessed 19 August 2008
  • Joint Formulary Committee, British National Formulary. 55th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008: 344-347
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: November 2008

 

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