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Travel Clinic and Clinic for Tropical Medicine in Munich > Malaria, Malaria Prophylaxis, Malaria Standby Test and Advice for Travellers >
Malaria Prophylaxis or Standby Treatment after Malaria Selftest?
Advice on malaria is one of my special expertise and I differ sometimes from official recommendations by bureaucrats.Often I prefer Doxycyclin as prophylaxis for severe malaria by plasmodium falciparum or chloroquine in benign malaria as prophylactic drugs to Lariam, Malarone and other due to the following reasons:
- No resistance known to Doxycyclin as prophylactic drug
- Doxycyclin and Chloroquine are considerably cheaper than other drugs
- Prophylaxis with Doxycyclin is possible until 1 day before travel
- Doxyciclyn prevents many infections not just malaria
- Doxicyclin has few side effects which are reversibel and usually harmless
- Doxycyclin is licenced for prophylactic use in USA, Australia, Kanada and UK
Chloroquine is still more effective against tertian malaria by Plasmodium vivax and ovale and therefore is my drug of choice in areas without the severe falciparum malaria.
Further in many cases I do not recommend any prophylaxis at all but to perform a standby malaria self-test in case of fever in a malarious area.
If the test is positive the patient can treat him/herself immediately by taking the correct drug for the respective type of malaria. This procedure has the advantage of avoiding unnecessary side effects of malaria medication from prophylactic intake when the risk of acquiring malaria is actually quite low. Fact is that the majority of travellers never get infected with malaria, however are still unnecessarily consuming millions of tablets for prophylaxis.
The other advantage is that malaria can be treated quickly when an early diagnosis is made but should be treated with the correct drug. The malaria test can help identifying which type of malaria has been acquired and which drug to be taken consequently, in order to avoid relapses several months later.
Especially frequent travellers into malarious regions such as travel guides, pilotes, rangers and the local population prefer this method and the general acceptance and level of quality of some malaria tests available allow standby treatment to be recommended.
