Prevention of Malaria and other Insect Borne Diseases during Travel
Malaria and other infectious diseases are a huge health problem among travelers. In many developed countries the cases of malaria are mainly of travelers returning from an malaria endemic area. The risk of contracting malaria depends on factors like area of travel, whether chemoprophylaxis is taken or not and the endemicity of malaria in the particular area.
The risk of contracting malaria vary if different parts of the world. Highest risk in sub-Saharan Africa and Oceania regions where it is estimated that the chance of contracting malaria is as high as 1 in 5 (1:5) to 1 in 50 (1:50) per month of stay, if chemoprophylaxis is not taken. The intermediate (malarious) areas are Indian subcontinent and in Southeast Asia where chance of contracting malaria is 1:250–1:1000 per month of stay. Low risk areas are South and Central America where the chance of contracting malaria is 1:2500–1:10,000 per month of stay.
In US more than 1000 cases of malaria are reported annually and out of these more than 90% are due to Plasmodium falciparum (most serious form of malaria and can involve brain and develop cerebral malaria). Almost all the cases are seen among travelers returning from or immigrating from Africa and Oceania.
There is worldwide increase in chloroquine- and multi drug-resistant falciparum malaria and the decision on chemoprophylaxis has become complicated. Recently there is spread of malaria due to primaquine- and chloroquine-resistant strains of Plasmodium vivax. This also has med the treatment of malaria more complicated. The case-fatality rate of falciparum malaria in the United States is 4% but the fact is only about one third of these fatal cases of malaria are diagnosed or thought of diagnosis of malaria before death.
Many studies indicate that less than 50% of the travelers follow the basic recommendations for malaria prevention. The main protective measure of malaria during travel are personal protection measures against mosquito bites (especially between dusk and dawn) and malaria chemoprophylaxis. The personal protection measures against mosquito bites include use of DEET-containing insect repellents, permethrin-impregnated bed-nets and clothing, screened sleeping accommodations, and protective clothing (the important motto of this is “sun down sleeves down†and for this traveler should use full sleeve dress). Personal protection measures against mosquito also help prevent other insect-transmitted illnesses, like dengue fever.
A new insect repellent with picaridin as active ingredient is quite efficacious and is available in the United States, but only in low-concentration formulations that require frequent reapplications. So, in regions where infections like malaria are transmitted (very high chance of transmission), DEET products (25–50%) are recommended, even for children and infants who are above 2 months of age.
CDC recommends the following anti malarial drugs for chemoprophylaxis according to region:
- Chloroquine: For Central America (north of Panama), Haiti, Dominican Republic, Iraq, Egypt, Turkey, northern Argentina, and Paraguay. Mefloquine, Doxycycline, Atovaquone + proguanil are the alternatives to Chloroquine.
- Mefloquine, Doxycycline, Atovaquone + proguanil (Malarone): Recommended for South America including Panama (except northern Argentina and Paraguay); Asia (including Southeast Asia), Africa and Oceania. Primaquine is an alternative to all the above.
- Doxycycline, Atovaquone + proguanil (Malarone): For Thai-Myanmar and Thai-Cambodian borders.
More From Healthyone
- Causes, Risk Factors and Signs and Symptoms of Ringworm
- Prevention and Control of Typhoid
- Emergence of Communicable Diseases due to Travel
Healthyone Recommends
- Blogging And Networking Both On And Offline (Chad Nicely)
- Small Business SEO Not Limited To Content And Back Linking (Chad Nicely)
Related posts:
