Information for Travelers
Malaria is a serious disease. Travelers should do everything they can to avoid getting bitten by mosquitoes (such as sleeping under netting; using insect repellent; and wearing long sleeves, pants, and socks). They should take antimalarial medicine, if there is a substantial risk of malaria in the country they will be visiting.
The three main malaria preventives - doxycycline, Lariam® (mefloquine) and Malarone® (atovaquone/proguanil) - offer similar levels of protection. Chloroquine is also appropriate in some parts of the world. Not every drug is right for every person, or appropriate for every location. The CDC, WHO, and UK Guidelines for Malaria Prevention make recommendations for countries all over the world. You and your health care provider need to review the information so you can decide which drug is right for you.
Adverse reactions to Lariam are quite common. Two recent published clinical trials - in Clinical Infectious Diseases (Overbosch) in 2001 and in the British Medical Journal (Schlagenhauf) in 2003 - find that 29% to 42% of people taking Lariam suffer from mild to moderate to severe neuropsychiatric side effects. Roche, Lariam's manufacturer, states the effects can last "long after" the drug has been stopped, without defining the length of time (Roche, 2003). Our experience indicates that although most effects disappear within months, some last for years, up to 10 years and longer. Physical adverse reactions can also be very severe and can include damage to the balance system.
Malaria and Antimalarial Drugs
CDC Information for the Public Prescription Drugs for Malaria
Guidelines for malaria prevention in travellers from the United Kingdom for 2003 (PDF). Commun Dis Public Health. 2003 Sep;6(3):180-99.
How to protect yourself from malaria (PDF). Advice from International Association for Medical Assistance to Travellers, 2003 (PDF format).
World Health Organization malaria fact sheet
- Central nervous system reactions related to the antimalarial drug, mefloquine, published 1989
- Additional information from WHO, correction 1989
- Review of central nervous system reactions related to the antimalarial drug, mefloquine (1985-1990), published 1991
Other FDA-Approved and Recommended Drugs That Prevent Malaria
Doxycycline:
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682063.html
Malarone:
PDF from maker of Malarone
Malarone has "better safety profile than older antimalarials" (including mefloquine). (August 23, 2002, release)
