Prophylaxis of malaria

Eli Schwartz, Eli Schwartz

Abstract

Malaria prevention in travelers to endemic areas remains dependent principally on chemoprophylaxis. Although malaria chemoprophylaxis refers to all malaria species, a distinction should be drawn between falciparum malaria prophylaxis and the prophylaxis of the relapsing malaria species (vivax & ovale). While the emergence of drug resistant strains, as well as the costs and adverse reactions to medications, complicate falciparum prophylaxis use, there are virtually no drugs available for vivax prophylaxis, beside of primaquine.Based on traveler's malaria data, a revised recommendation for using chemoprophylaxis in low risk areas should be considered.

Figures

Figure 1
Figure 1
Malaria Life cycle (partial illustration). Blood stage prophylaxis: Drugs which act on the malaria parasites only within the erythrocytes. (such as: Mefloquine, Chloroquine, Amodiaquine). They have to be continued therefore for 1 month after leaving the malarious area. As can be seen in the figure, late infections will not be prevented. Liver stage prophylaxis: Drugs which act on the malaria parasites within the hepatocytes (such as Primaquine and Malarone). It is sufficient to continue the drug for a few days after leaving the endemic area. However, only primaquine potentially may prevent all types of malaria including the late infection.
Figure 2
Figure 2
Vivax prophylaxis Strategy

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