Malaria, a potentially life-threatening disease transmitted by mosquitoes, is prevalent in many parts of the world. It takes one single bite from a Plasmodium parasite-infected mosquito for an individual to get sick with malaria. 

When travelling to a malaria-endemic area, being well-prepared is essential to ensuring a safe and enjoyable journey. Knowing the A, B, C, Ds of malaria is crucial for prevention, early detection, and effective treatment. “C” is for CHEMOPROPHYLAXIS. This article provides information about the importance of taking prophylaxis when travelling to a malaria-endemic area, be it for business or pleasure.

The University of Pretoria Institute for Sustainable Malaria Control creates a platform for diverse experts to bring their unique skills and knowledge to the table and join forces to address malaria holistically.

Malaria prevention in pill form

Malaria chemoprophylaxis refers to the use of medications to prevent the development of malaria in individuals at risk of contracting the disease. The term "chemoprophylaxis" combines "chemo," referring to chemical or drug-related, and "prophylaxis," meaning preventive treatment. Prophylactic medications are a critical component of travel safety in malaria-endemic areas and are highly recommended for high-risk areas. Prophylaxis act as a protective shield against malaria parasites, with the goal to suppress them in the bloodstream before they cause clinical illness

Malaria chemoprophylaxis can significantly reduce the risk of contracting malaria when used correctly and consistently. Consistent and correct use of the prescribed medication is crucial for its effectiveness. Skipping doses or discontinuing the medication prematurely can reduce its protective effect and increase the risk of malaria.

The choice of antimalarial medication depends on factors such as the specific geographic location, the species of malaria parasite prevalent in the area, the local pattern of anti-malarial drug resistance in the area, and personal characteristics such as the individual's health status and any contraindications or side effects associated with the drugs.

Before initiating malaria chemoprophylaxis, individuals should consult with a doctor or healthcare professional. The choice of medication and the appropriate dosage depend on factors such as the individual's health, the destination, and the duration of stay. Consult with a healthcare professional before your trip to determine the most suitable prophylactic medication for your destination. There are over-the-counter options available, but if you are a first-time user, speak with a doctor.

Chemoprophylaxis facts and fallacies

A question often asked about prophylaxis and its use is whether it masks the symptoms of malaria. The answer to this is "no."

The goal of taking malaria prophylaxis is to:

• Lessen severity: In the event of breakthrough infections (when individuals contract malaria despite taking prophylaxis), the severity of the disease is often reduced. Prophylactic medications can help prevent complications and severe forms of malaria.
• Prevent deaths: Malaria can be a life-threatening disease, especially if caused by the Plasmodium falciparum parasite. By taking prophylaxis, individuals are less likely to develop severe malaria, which can result in fatalities
• Promote health: Malaria can cause significant illness and negatively impact an individual's health. By using chemoprophylaxis, individuals can maintain their well-being, avoid the discomfort of malaria symptoms, and continue their daily activities without interruption.
• Public health impact: In regions where malaria is endemic, widespread use of chemoprophylaxis can contribute to reducing the overall burden of the disease.

It is important to understand that taking antimalarial prophylaxis does not guarantee absolute protection. Breakthrough infections can occur. Chemoprophylaxis significantly reduces the risk of contracting severe malaria, though only when used correctly and consistently. The initial stages of the disease may be less severe, and symptoms may be slower to appear. The ultimate aim is to buy yourself enough time in which to seek medical help. To ensure closer to 100% protection, individuals should also take additional precautions to avoid mosquito bites and seek prompt medical attention if they experience any symptoms of malaria during or after their stay in malaria-endemic areas.

Final tips

Women who are pregnant or likely to become pregnant are advised not to travel to malaria-endemic areas, if possible. Malaria in pregnant women can be more severe than in non-pregnant women. It can increase the risk of serious pregnancy problems, including prematurity, miscarriage, and stillbirth. If you have young children (under five years of age), it is also advised to not include them in your travels. They are considered to be one of the most, if not the most, susceptible groups to malaria.

Thorough preparation is essential before embarking on your journey to a malaria-endemic region. Start by researching your destination to understand the local malaria risk. The World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC) provide valuable information and recommendations for specific areas.

Travel safety in malaria-endemic areas demands a proactive approach. Prepare meticulously, ensure you pack appropriate clothing and repellent to protect yourself from mosquito bites, don’t forget your malaria pills, and keep an eye open for any symptoms.

For more information, visit the webpage of the University of Pretoria Institute for Sustainable Malaria Control, a multi-disciplinary research institute making a substantial contribution towards the creation of a malaria-free Africa.

Read more from the Malaria 101 series