Your Essential Guide to Malaria Prevention
Traveling to a malaria-risk area? Our comprehensive guide provides clear, personalized information on prevention drugs, guidelines, and an interactive questionnaire to help you make informed decisions for a safe journey.
Malaria Prevention Medications
Below is a comparison of common malaria prevention drugs. Always consult with a healthcare professional for personalized advice.
| Drug Name | Start Before Travel | Frequency (During Travel) | Continue After Travel | Key Contraindications |
|---|---|---|---|---|
| Atovaquone/Proguanil (Malarone) | 1-2 days | Daily | 7 days | Pregnancy, breastfeeding (<5kg infant), severe renal impairment |
| Doxycycline | 1-2 days | Daily | Pregnancy, children <8 years, severe sun exposure | |
| Mefloquine | 1-2 weeks | Weekly | Psychiatric conditions, seizure disorder, cardiac conduction abnormalities | |
| Chloroquine | 1-2 weeks | Weekly | Chloroquine/Mefloquine resistance areas, psoriasis | |
| Primaquine | 1-2 days | Daily | G6PD deficiency (or untested), pregnancy, breastfeeding (unless infant G6PD tested) | |
| Tafenoquine (Arakoda) | 3 days | Weekly | G6PD deficiency (or untested), children, pregnancy, breastfeeding, psychotic disorders |
Dosage & Schedule:
- Adults: 1 adult tablet daily.
- Children: Doses vary by weight (e.g., 5-8 kg: ½ pediatric tablet daily; 40 kg and over: 1 adult tablet daily).
- Begin 1-2 days before travel, daily during travel, and for 7 days after leaving.
Reasons to Consider:
- Good for last-minute travelers (start 1-2 days before).
- Daily medicine preferred by some.
- Good choice for shorter trips (only 7 days after travel).
- Very well tolerated, side effects uncommon.
- Pediatric tablets available.
Reasons to Avoid:
- Cannot be used by pregnant women or breastfeeding a child less than 5 kg.
- Cannot be taken by people with severe renal impairment.
- Tends to be more expensive for long trips.
- Some people prefer not to take medicine every day.
Dosage & Schedule:
- Adults: 100 mg daily.
- Children: ≥8 years old: 2.2 mg/kg (maximum adult dose) daily.
- Begin 1-2 days before travel, daily during travel, and for 4 weeks after leaving.
Reasons to Consider:
- Daily medicine preferred by some.
- Good for last-minute travelers (start 1-2 days before).
- Tends to be the least expensive antimalarial.
- May prevent other infections (e.g., Rickettsiae and leptospirosis).
Reasons to Avoid:
- Cannot be used by pregnant women and children <8 years old.
- Increased risk of sun sensitivity.
- May increase likelihood of vaginal yeast infections in women.
- Potential for upset stomach.
- Requires 4 weeks of post-travel medication.
Dosage & Schedule:
- Adults: 228 mg base (250 mg salt), weekly.
- Children: Doses vary by weight (e.g., ≤9 kg: 4.6 mg/kg base weekly; >45 kg: 1 tablet weekly).
- Begin 1-2 weeks before travel, weekly during travel, and for 4 weeks after leaving.
Reasons to Consider:
- Weekly medicine preferred by some.
- Good choice for long trips.
- Can be used during pregnancy.
Reasons to Avoid:
- Cannot be used in areas with mefloquine resistance.
- Cannot be used in patients with certain psychiatric conditions or seizure disorder.
- Not recommended for persons with cardiac conduction abnormalities.
- Not a good choice for last-minute travelers (needs 2 weeks prior).
- Requires 4 weeks of post-travel medication.
Dosage & Schedule:
- Adults: 300 mg base (500 mg salt), once/week.
- Children: 5 mg/kg base (8.3 mg/kg salt) (maximum adult dose), once/week.
- Begin 1-2 weeks before travel, once/week during travel, and for 4 weeks after leaving.
Reasons to Consider:
- Weekly medicine preferred by some.
- Good choice for long trips.
- Can be used in all trimesters of pregnancy.
Reasons to Avoid:
- Cannot be used in areas with chloroquine or mefloquine resistance.
- May exacerbate psoriasis.
- Not a good choice for last-minute travelers (needs 1-2 weeks prior).
- Requires 4 weeks of post-travel medication.
Dosage & Schedule:
- Adults: 30 mg base daily.
- Children: 0.5 mg/kg base up to adult dose daily.
- Begin 1-2 days prior to travel, daily during travel, and for 7 days after leaving.
Reasons to Consider:
- One of the most effective medicines for preventing P. vivax.
- Good choice for shorter trips (only 7 days after travel).
- Good for last-minute travelers (start 1-2 days before).
- Daily medicine preferred by some.
Reasons to Avoid:
- Cannot be used in patients with glucose-6-phosphatase dehydrogenase (G6PD) deficiency or if untested.
- Cannot be used by pregnant women.
- Cannot be used by women who are breastfeeding unless the infant has also been tested for G6PD deficiency.
- Potential for upset stomach.
Dosage & Schedule:
- Adults only: 200 mg per dose.
- Begin daily for 3 days prior to travel, weekly during travel, and for 1 week after leaving.
Reasons to Consider:
- One of the most effective drugs for prevention of P. vivax and P. falciparum.
- Good choice for shorter trips (only 1 week after travel).
- Good for last-minute travelers (start 3 days before).
Reasons to Avoid:
- Cannot be used in patients with glucose-6-phosphatase dehydrogenase (G6PD) deficiency or if untested.
- Cannot be used by children, pregnant women, or breastfeeding women.
- Not recommended in those with psychotic disorders.
Geographic Guidelines & Malaria Risk Map
Malaria risk varies significantly by geographic region. Consult this map and the descriptions below to understand the risk level for your destination.
Understanding the Map:
Regions are color-coded to indicate varying levels of malaria risk: High Risk (e.g., Sub-Saharan Africa, parts of Oceania), Moderate Risk (e.g., parts of South Asia, Southeast Asia, South America), and Low/No Risk.
General Guidelines:
- Always use personal protective measures (insect repellent, long sleeves/pants, bed nets) in risk areas.
- Consult with a healthcare provider 4-6 weeks before travel to determine specific drug recommendations based on your itinerary and health profile.
- Be aware of drug resistance patterns in your destination.
Region-Specific Information:
Africa (Sub-Saharan): Generally high risk for P. falciparum malaria. Atovaquone/Proguanil, Doxycycline, and Mefloquine are commonly recommended. Chloroquine is generally not effective due to widespread resistance.
Southeast Asia: Risk varies. Resistance to some drugs (like Mefloquine in certain areas) exists. Atovaquone/Proguanil and Doxycycline are often recommended.
South America (Amazon Basin): Risk varies by specific location. P. vivax is common. Primaquine or Tafenoquine may be considered in addition to standard drugs, after G6PD testing.
Central America & Caribbean: Generally lower risk, with some areas having very low or no risk. Chloroquine may still be effective in limited areas, but always verify current resistance patterns.
Personalized Drug Recommendation Questionnaire
Frequently Asked Questions
Malaria is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. People who get malaria are usually very sick with high fevers, shaking chills, and flu-like illness. If not promptly treated, it can lead to severe complications and death. It is transmitted through the bite of an infected female Anopheles mosquito.
Personal protective measures are crucial even if you are taking antimalarial drugs. These include using insect repellent containing DEET, wearing long-sleeved shirts and long pants, and sleeping under insecticide-treated bed nets, especially from dusk till dawn when mosquitoes are most active. No antimalarial drug is 100% effective, so combining strategies offers the best protection.
It is highly recommended to consult a travel health specialist or your doctor at least 4-6 weeks before your trip. This allows enough time for vaccinations to become effective and for you to start your antimalarial medication, as some require being taken for a week or two before entering a malaria-risk area. They can assess your specific travel itinerary, health history, and current medications to recommend the most appropriate prevention strategy.