Do Anti-Malaria Tablets Prevent Malaria?

Malaria is a serious and potentially life-threatening disease caused by mosquitos that carry a parasite known as Plasmodium.

Female mosquitoes require blood in order to nurture their eggs, so when an infected female mosquito belonging to the Anopheles type bites a human being, it can be the start of Malaria. During this process, the mosquito will inject its saliva into the human. The mosquitoes saliva contains a mixture of chemicals which act as an anticoagulant in order to thin the human blood, making it easier for the mosquito to suck. An infected mosquito’s saliva will contain the Plasmodium parasite, and when the mosquito injects its saliva into the human, it mixes with the human blood. This is the critical point, as this is when the infected saliva of the mosquito comes into contact with blood, infecting the human. The parasites then enter the human blood stream and travel to the liver, as it provides optimum conditions for the parasites to survive, reproduce and prepare for invasion. Once the parasites have multiplied significantly, they leave the liver, they then enter red blood cells (which are responsible for carrying oxygen around the whole body). They infect the red blood cells causing them to rupture, entering more red blood cells and releasing toxins. It usually takes a few weeks for the parasites to get to this stage, however it could be sooner or later (even as long as a year).

Once the parasites are in the blood stream in abundance, they begin to destroy red blood cells. Red blood cells are responsible for carrying oxygen around your body, which means that vital organs and tissues such as your brain and lungs are starved of oxygen. Damaged red blood cells clog up blood vessels which not only limit blood supply to the rest of your body, but also act as a shield so that the parasite can hide from the immune system. Eventually, if left untreated, your body will shut down and malaria will ultimately result in death.

The good news however, is that although malaria can be life-threatening, it can be prevented. The not so good news, is that preventing malaria requires you to take anti-malaria tablets. The type of tablets that you take, depend on where in the world you are visiting. Some antimalarials may only be suitable for certain parts of the world, so it is important to check that the anti-malaria tablets you take, provide protection for that region. You can check if you need antimalarials and which ones are suitable by visiting the NHS Fit For Travel website. Most anti-malaria tablets require a prescription from the doctor, however, modern technology now allows for you to be prescribed anti-malaria tablets online, without having to make an appointment with a doctor. Whether you choose to make an appointment with a doctor, or have an online consultation, the type of antimalarial prescribed will be based on:

• Where you are going
• Your past medical history (such as allergies)
• What medication you are currently taking (to ensure there are no
• interactions)
• Any issues you may have had in the past with antimalarials
• Whether you are pregnant or breastfeeding
• Your age
• Your weight

There are three main type of anti-malaria tablets

Atovaquone plus proguanil (also known as Malarone)

Dosage

• One tablet to be taken every day, starting two days before entering the malaria
  zone, throughout your stay, and for seven days after having left the malaria zone

Pros

• Available as a generic (non-branded) version, therefore has a cheaper option
• Has the lowest side-effect profile in comparison to other antimalarials
• Only needs to be taken for seven days after having left the malaria zone
• Good for last minute travellers as it only needs to be taken one to two days before travel

Cons

• Cannot be used by women who are pregnant or breastfeeding, or those with kidney problems
• Can be more expensive in comparison to other options
• Needs to be taken daily

Doxycycline

Dosage

• One doxycycline tablet to be taken every day, starting two days before entering the malaria zone, throughout your stay, and for four weeks after having left the malaria zone

Pros

• Tends to be the least expensive of the antimalarials and is affordable for most
• Good for last minute travellers as it only needs to be taken one to two days before travel

Cons

• Cannot be used by pregnant women and children below the age of 8
• Needs to be taken for 4 weeks after having left the malaria zone
• Causes sensitivity to sunlight which can cause sunburn
• Can cause stomach upset

Mefloquine (also known as Lariam)

Dosage

• One tablet weekly, starting three weeks before entering malaria zone, throughout your stay, and for four weeks after leaving malaria zone

Pros

• Some may prefer to be taking tablets on a weekly basis rather than every day
• Can be used during pregnancy
• Cost-effective option

Cons

• Not an option for last minute travellers as it needs to be started three weeks before travel
• Cannot be taken for people with certain heart conditions, seizures or psychiatric problems
• Is known to cause stomach upset and hallucinations

All antimalarial’s have been scientifically proven to prevent malaria. There is no such thing as the “best anti-malaria tablet”. What is important is that you research the various options and choose which one is best suited for you and your trip. Atovaquone/proguanil (Malarone) continues to be a popular choice amongst many travellers, due to its low side-effect profile, but it’s down to personal preference, and which one is clinically suitable for you.

If malaria is diagnosed and treated quickly, most people will make a full recovery. It is important to be aware of the signs and symptoms of malaria, so that treatment can be commenced as soon as possible. However, it is always best to be safe and responsible by taking preventative measures such as anti-malaria tablets.