ANTIMALARIALS

Chemoprophylaxis is the strategy that uses medications before, during, and after the exposure period to prevent the disease caused by malaria parasites. The aim of prophylaxis is to prevent or suppress symptoms caused by blood-stage parasites.

In addition, presumptive anti-relapse therapy (also known as terminal prophylaxis) uses medications towards the end of the exposure period (or immediately thereafter) to prevent relapses or delayed-onset clinical presentations of malaria caused by hypnozoites (dormant liver stages) of P. vivax or P. ovale.

General Recommendations for Prophylaxis

Chemoprophylaxis should continue during travel in the malarious areas and after leaving the malarious areas (4 weeks after travel for chloroquine, mefloquine, and doxycycline, and 7 days after travel for atovaquone/proguanil and primaquine).

In comparison with drugs with short half-lives, which are taken daily, drugs with longer half-lives, which are taken weekly, offer the advantage of a wider margin of error if the traveller is late with a dose. For example, if a traveller is 1-2 days late with a weekly drug, prophylactic blood levels can remain adequate; if the traveller is 1-2 days late with a daily drug, protective blood levels are less likely to be maintained.

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