Prevention of malaria

Article Abstract:

Malaria was eliminated in the US by the early 1950s, but still infects a significant number of people in other parts of the world and can infect Americans who travel to such countries if they do not take appropriate preventive measures. An article in the January 16, 1990 issue of The Journal of the American Medical Association describes the progression of Plasmodium falciparum malaria (one form of the malarial parasite) from East to West Africa. This developed simultaneously with a decline in the effectiveness of chloroquine, which has long been the remedy of choice, against the disease. This formerly almost-ideal drug must now be replaced by other agents, one of which is mefloquine hydrochloride, approved by the Food and Drug Administration in 1989. This agent, discovered more than 20 years ago, is effective against all four human malarial strains. However, certain characteristics associated with mefloquine make determination of an optimal dose regimen difficult. The Journal article reports 17 failures of malaria prophylaxis with this drug, all occurring in the second week of a two-week drug administration regimen. Blood levels of the drug are low at this time; as a result of this report, weekly dosing is now recommended. Antimalarial drugs focus on killing the parasite after it has invaded the red blood cells, rather than earlier in its life cycle, when it is developing within liver cells. Other agents with different actions are needed. Furthermore, even the best preventive pharmacologic measures must be combined with the use of bed netting, insect repellents, and protective clothing. Malarial symptoms, which can develop as long as two years after exposure, require prompt attention to avert fatalities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Demographic aspects, Drug therapy, editorial, Mefloquine

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Update on prevention of malaria for travelers

Article Abstract:

Mefloquine is the preferred drug to prevent malaria in those traveling to countries with the disease. Malaria is a parasitic infection spread by mosquitoes that affects up to 30,000 North American and European travelers each year. Parasitic resistance to chloroquine, a drug used since the 1940's, has developed in most endemic areas in Africa, Asia and South America. Resistance to mefloquine in Southeast Asia has raised concern about the long-term utility of this drug. Insect repellants and screens reduce contact with mosquitoes and are important means of preventing malaria.

Health aspects, Safety and security measures, Antimalarials, Travelers

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