For details on anti-malarial medication dosages and side-effects, including comprehensive protection measures, see IAMAT's publications HOW TO PROTECT YOURSELF AGAINST MALARIA and WORLD MALARIA RISK CHART.
In offering guidance on the choice of anti-malarial drugs, the main concern is to provide protection against P. falciparum malaria. To prevent this fatal form of the disease, chloroquine is the drug of choice where the parasites are still sensitive to it. Chloroquine is also the preferred drug for the suppression of the benign forms of malaria, but it will not always prevent a delayed first attack or relapses due to Plasmodium vivax and Plasmodium ovale.
The appearance of chloroquine resistant and multi-drug resistant P. falciparum in many malarious areas makes the choice of suppressive drugs problematic as none of the medications currently used are 100% effective. Regardless of the medication taken, it is of utmost importance to consider fever and flu-like symptoms appearing seven days up to several months after leaving a malaria area as a malaria breakthrough. Early diagnosis is essential for successful treatment.
A high incidence of chloroquine-resistant and/or multi-drug resistant Plasmodium falciparum malaria is present in this country. Follow ONE of the following suppressive medication regimens:
In countries with highly chloroquine-resistant P. falciparum malaria, a REGIMEN OF PALUDRINE (proguanil hydrochloride) 200mg DAILY (adult dose) SHOULD BE ADDED TO THE WEEKLY CHLOROQUINE REGIMEN.
PERSONS FOLLOWING A CHLOROQUINE OR A CHLOROQUINE PLUS PROGUANIL HYDROCHLORIDE REGIMEN MUST BE AWARE THAT THESE DRUGS ARE MUCH LESS EFFECTIVE THAN LARIAM, MALARONE OR DOXYCYCLINE. SEEK IMMEDIATE MEDICAL ATTENTION IN CASE OF FLU-LIKE SYMPTOMS - FEVER, HEADACHE, NAUSEA, GENERAL MALAISE - APPEARING ABOUT SEVEN DAYS OR LATER AFTER ENTERING MALARIOUS AREA.
Persons travelling to or working in remote areas where medical attention cannot be sought within 24 hours should consult with a specialist before leaving their home country for advice on a possible self-treatment regimen in case of a malaria breakthrough attack. For description of anti-malarial drugs see IAMAT's publication HOW TO PROTECT YOURSELF AGAINST MALARIA.