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Malaria – Drugs to Protect You When Traveling

About Malaria – A Short Primer

Malaria is spread by the Anopheles mosquito and no other. When they land on you to suck your blood they pass the Plasmodium parasites to you, which in turn infect and make you sick. That’s why there’s no anti-virus yet: malaria is a parasitic infection, complicated by the fact that there are five species of the parasite.

It is the female mosquito which passes the infection, and it’s not likely you will even notice the bite: the female Anopheles is tiny, light and silent. Her nickname is ‘The Silent Killer’.

As explained, there is no vaccine against malaria, only drugs which mask the symptoms and prevent them from becoming acute. Many have ceased to be of any benefit as mosquitoes in certain regions pass a form of malaria resistant to these drugs. You will read of ‘prophylaxis’ in the context of malaria. This term refers to the prevention or protection from a particular disease. This may include drugs, but it also includes avoidance of exposure in the first place.

The Current Drugs

The drug Malarone was introduced in 1998 and is very effective as a malarial prophylaxis (preventative). Unfortunately it’s what’s known as an anti-folate, a class of drugs used in chemo therapy. It damages the bone marrow, skin and hair and is extremely harmful to a pregnant woman. For these reasons prolonged usage (such as more than 30 days) is thought to be unwise. Even in 2010 this was not understood widely and travelers were taking Malarone daily for a year or more, myself included. It doesn’t help that Malarone is also rather expensive.

Fortunately there is an antibiotic, Doxycycline, which is recommended by the US government and the NHS in the UK, among others. This requires a 100mg dose daily for two days before potential exposure and then four weeks after. It is 90% effective in inhibiting the development of malaria.

Doxycycline is known to be safe for six months (NHS) or one year (US guidance) or two years according to various schools of tropical medicine (see below). Commonly prescribed for acne, and also for less pleasant conditions, the only notable side effects are an increased sensitivity to sunlight when you first start with the drug and an increased risk of sunburn. Women risk vaginal thrush as it is a wide spectrum anti biotic. It’s also very inexpensive and available world-wide.


There are up to 500 million cases of malaria annually causing an estimated 1 million deaths. Treatment is critical. It’s made trickier because the symptoms don’t appear until some 10 day to 28 days after the infective bite.

Since the treatment depends on the type of malaria, and this is only determined through a blood test and microscopic examination, there is no self treatment. In less sophisticated regions the adage assumed by clinicians and physicians is simply ‘Fever equals malaria unless proven otherwise’. The most dangerous form of malaria is P. falciparum which can kill in days. It is this strain which is the most common in Africa.

Notwithstanding the above, the are malarial self-tests which are particularly good for travelers. So called Malaria ‘Dip Sticks’ require a drop of blood as from a finger prick and the South African Centre for Disease Control states the many such test kits available are all about equally effective, the good news is that they are optimized for detecting P. falciparum.


  • Flu-like Fever, headache, sweats, chills Vomiting Diarrhoea Dizziness

The fever may often include one hour of severe chills followed by a fever of two to six hours.

While it could be flu, it probably isn’t. Get checked! Better yet, don’t get bitten in the first place, but that’s another topic.

Emergency Treatment

While any suspected case of malaria demands medical attention, such is the nature of travel that this isn’t always practical. Therefore the following steps may be taken until gaining access to a medical specialist:


4 tablets daily for 3 days


6 doses over 60 hours (24 tablets)

Qing Hausu

(brands such as Cotexin, Arsumox, Artemether). Used with Doxycycline.

My preference, based on medical advice, is to carry a small stock of Malarone. Treating suspected malaria in this way cannot cause any harm.

I hope this concise guide helps in your understanding of Malaria and in planning your own strategy. Remember, though, nothing is 100% effective so you must still put all efforts towards not getting bitten.

Humperdinck Jackman