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Submitted by Ted Lankester on May 28, 2003 - 12:00am.
This can seem a confusing topic for many aid workers; even for doctors and nurses. Most advice is directed towards the short-term traveller, so here are some guidelines for those going away for a month or longer. It is based on information from the WHO, UK Advisory Committee on Malaria Prevention, our experience at InterHealth in caring for members of 180 NGOs and from other reliable sources.
Here is a simple tour:
FIRST - Avoid getting bitten. That means mozzie nets, DEET based insect repellent, cover-up and loads of common sense. Easy - but very dangerous - to forget.
SECOND - Take an effective antimalarial.
The rest of this section applies to Sub Saharan Africa - far and away the most risky areas for most of us. Always make sure you read the Patient Information Leaflet because not all side effects and reasons for not taking them are listed below.
You have 3 choices:
And then there is chloroquine and proguanil (Paludrine). These are no longer sufficiently effective to use in Sub Saharan Africa (SSA)- though pregnant women in their first third of pregnancy have no safe alternative. Otherwise if you are taking C plus P in SSA consider changing to a more effective antimalarial as soon as possible.
Maloprim or Deltaprim. This is still widely used in Zimbabwe, Zambia and other surrounding countries. However there is increasing resistance and it can no longer be recommended as a main line antimalarial.
Other parts of the world? - more complicated - you will need to get specialist advice.
Before signing off two other important things to mention:
This short piece is about prevention - treatment is of course vital but you will have to wait to hear about that until another time - unless you want to order a copy of the Travellers Good Health Guide. (Ted Lankester, Sheldon Press 2002). This and a full range of antimalarials and health supplies are available from InterHealth: email firstname.lastname@example.org, telephone +44 20 7902 9000 or look at the website www.interhealth.org.uk
For agencies or individuals who receive other services or supplies from InterHealth or for whom InterHealth acts as travel health/medical advisor we have an arrangement with Glaxo Smith Kline who have generously made Malarone (and Combivir for Post-Exposure Prophylaxis of HIV) available at greatly reduced cost for those working in Least Developed Countries.
Thanks for reading this - Safe travelling ...
Ted Lankester and the InterHealth team.
(Neither the writer, InterHealth nor Aid Workers Network can take any responsibility for adverse events which may arise from any of the advice or recommendations given above)
Dr Ted Lankester is Director of Health Care Services and Senior Physician at InterHealth, a UK based medical charity which acts as health advisor to relief and development organisations, mission agencies, churches and other not-for-profit organisations. For more information visit www.interhealth.org.uk
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