Christian Heesch discusses Malaria Prevention for People traveling to West Africa

An infection with falciparum malaria is a significant threat to people traveling from the United States to West Africa. We asked Christian Heesch, a physician with work experience in West-Africa, how to protect against this potentially deadly disease.

“Before you travel”, Christian Heesch said, “talk to your doctor about your travel plans, and consider a consultation with a travel-medicine specialist. Get the appropriate vaccinations, and get medication to prevent malaria. Once you are there, make sure you get as few mosquito bites as possible. Anopheles mosquitoes mostly feed from the beginning of dusk to the end of dawn – but no time of the day is really safe. It is definitely safest to avoid the outdoors except during the daytime” Christian Heesch observed.

“Effective insect-repellent is a must. DEET (N,N-diethyl-m-toluamide) has a long track-record and seems safe for people older than two months. I suggest using a concentration of at least 25%, but 50% sprays are more effective and last longer. After dark, wear long-sleeved shirts and long pants. Also, clothing can be impregnated with permethrin to prevent bites, and pre-treated clothing is available. Always, always use mosquito bed-nets at night-time, especially pyrethroid treated nets.” Christian Heesch also said: “Remember that such treated bed-nets and clothing will lose their effectiveness over time, especially with washing, and reapplication insecticide is often necessary.”

“Most regions of the world where malaria is endemic have now reported Chloroquine resistant falciparum malaria”, Christian Heesch observed, “and this medication is not effective as single agent prophylaxis in West-Africa. Atovaquone/Proguanil (Malarone) is administered every day, it is mostly well tolerated and it works. Pregnant or breastfeeding women should not take Malarone, and it cannot be taken in severe renal insufficiency. Doxycycline is much cheaper, but increases sensitivity to the sun. Children should not take the drug before the age of 8 (some guidelines suggest 12) years, and doxycycline must not be given to pregnant or breastfeeding women. Mefloquine (Lariam) needs to be taken only once-weekly, but it has many contraindications, including but not confined to seizures, many psychiatric conditions, many heart rhythm problems, a history of Blackwater fever, or significant liver problems. Also, Mefloquine is metabolized through CYP3A4. This may lead to potential problems when drugs are co-administered that inhibit this enzyme.” Christian Heesch also pointed out: “I strongly suggest that you buy your medications, for malaria prophylaxis and whatever else you may need, in the US. Locally purchased drugs may be counterfeit.”

Christian Heesch reiterated: “All travel plans, and all medication needs, should always be addressed with the personal physician and with a travel-medicine specialist.” As a good additional source of information, he recommends and

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Written by Acclaimed Internet Writer Duke Hammerton