The information supplied is derived from a number of reliable sources and is compared and compiled into the alphabetical lists found on this web site.
Countries requiring malaria prophylaxis should be regarded as being at risk all year round and you should also assume that the whole country is at risk unless otherwise indicated. The malaria regimen is the recommended regimen for a country. Use of the incorrect regimen may not provide adequate cover.
When there are two different regimens for the same country, they are area specific. Read the text to find out which regimen is suitable for the area you require.
Where regimen 1 is indicated there is Chloroquine resistance in that region and it is very likely to be the Falciparum malaria which is the most serious form of the disease. In this instance it is vitally important that travellers take adequate prophylaxis.
Remember:- No prophylaxis is 100% effective but not taking anti-malarials where they are indicated will put you at greater risk should you get the disease. Remember - Malaria is a killer! |
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The Different Drug Regimens |
| Regimen 1 | Mefloquine one 250mg tablet weekly. OR
Doxycycline one 100mg capsule daily. OR
Malarone one tablet daily. |
| Regimen 2 | Chloroquine 300mg weekly (2x150mg tablets). PLUS
Proguanil 200mg daily (2x100mg tablets). |
| Regimen 3 | Chloroquine 300mg weekly (2x150mg tablets) ORProguanil 200mg daily (2x100mg tablets). |
| Regimen 4 | No prophylactic tablets required but anti mosquito measures should be strictly observed: Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net. |
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| Proguanil | 100mg tablets are supplied as Paludrine Tablets |
| Chloroquine | 150mg tablets are supplied as Nivaquine or Avloclor Tablets |
| Mefloquine | 250mg tablets are supplied as Lariam Tablets |
| Malarone | is a combination of Atovaquone 250mg and Proguanil 100mg |
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Length of Prophylaxis |
| Chloroquine, Proguanil & Maloprim | Start one week before travel, throughout your stay in an endemic area and continue for four weeks after return. |
| Mefloquine (Lariam) | Start two and a half weeks before travel, throughout your stay in an endemic area and continue for four weeks after return. |
| Doxycycline | Start two days before travel, throughout your stay in an endemic area and continue for four weeks after return. |
| Malarone | Start two days before travel, throughout your stay in an endemic area and continue for one week after return. |
IMPORTANT!
Take the tablets absolutely regularly, preferably with or after a meal. |
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Long Term Use of Anti-Malaria Drugs |
| Chloroquine | May be taken for periods exceeding five years. |
| Paludrine | May be taken for periods exceeding five years. |
| Maloprim | Can be taken for periods up to one year. |
| Mefloquine | Can be taken for periods up to one year. |
| Doxycycline | Can be taken for periods up to six months. |
| Malarone | Can be used for travel periods up to one year. |
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Compatibility of Anti-Malaria Drugs |
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Pregnancy |
Breast Feeding |
Epilepsy |
Psoriasis |
Altitude |
Scuba Diving |
| Chloroquine |
OK |
OK |
NO |
NO |
OK |
OK |
| Paludrine |
OK |
OK |
OK |
OK |
OK |
OK |
| Mefloquine |
OK* |
NO |
NO |
OK |
NO |
NO |
| Doxycycline |
NO |
NO |
OK |
OK |
OK |
OK |
| Malarone | NO | NO | OK | OK | OK | OK |
* These drugs are not suitable during the first trimester of pregnancy. |
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Childrens' Dosages:
Calculate the dose by weight rather than by age if possible |
Age/Weight | Chloroquine
(once weekly) | Proguanil
(once daily) | Mefloquine
(once weekly) | Doxycycline
(once daily) | Malarone
(once daily) |
0 - 12 weeks
under 6kg | 1/4 tablet | 1/4 tablet | - | - | - |
3 - 12 months
6 - 10kg | 1/2 tablet | 1/2 tablet | 1/4 tablet | - | - |
1 - 3 years
10 - 16kg | 3/4 tablet | 3/4 tablet | 1/4 tablet | - | 1 child's
tablet |
4 - 7 years
16 - 25kg | 1 tablet | 1 tablet | 1/2 tablet | - | 1 child's
tablet |
8 - 12 years
25 - 45 Kg | 11/2 tablets | 11/2 tablets | 3/4 tablet | - | 2 child's
tablets |
13 years and over
45kg and over | 2 tablets | 2 tablets | 1 tablet | 1 capsule | 1 adult
tablet |
The above dosages are based upon the guidelines issued by
the Advisory Committee on Malaria Prevention. |
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Adult Dosages |
Regimen | Dose for
Chemoprophylaxis | Usual amount
per tablet (mg) |
| Areas without drug resistance: |
Chloroquine
Proguanil | 2 tablets weekly
2 tablets daily | 150mg (base)
100mg |
| Areas of little chloroquine resistance (poorly effective where marked resistance): |
| Chloroquine plus Proguanil | 2 tablets weekly
2 tablets daily | 150mg (base)
100mg |
| Areas of chloroquine resistant P. falciparum: |
Mefloquine
Doxycycline
Malarone
(atovaquone & proguanil) | 1 tablet weekly
1 tablet/capsule daily
1 tablet daily | 250mg (228 in USA)
100mg
250mg atovaquone &
100mg proguanil |
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| Countries where there is currently no risk of malaria: |
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| Malaria prophylaxis for Sub-Saharan Africa |
|
Risk | Country | Preferable
regimen | Alternative
regimen |
| Low risk | - Cape Verde - Remember, low risk if fever develops.
- Mauritius - Except a few rural areas where chloroquine prophylaxis is appropriate.
| Avoid insect bites. | |
| Risk in parts of the country Some chloroquine resistance present. | - Botswana - Only in the northern half of the country - November to June.
- Mauritania - All year round in the south. November to June in the north.
- Zimbabwe - Areas below 1,200 metres - November to June. All year long in the Zambezi Valley where Doxycycline, Mefloquine or Malarone are preferable. Risk is negligible in Harare and Bulawayo.
| Chloroquine
PLUS
Proguanil | Doxycycline
OR
Mefloquine
OR
Malarone |
| Risk very high, or locally very high. Chloroquine resistance very widespread. |
- Angola
- Benin
- Burkina Faso
- Burundi
- Cameroon
- Central African Republic
- Chad
- Comoros
- Congo
- Djibouti
- Equatorial Guinea
- Eritrea
| - Gabon
- Gambia
- Ghana
- Guinea
- Guinea Bissau
- Ivory Coast
- Kenya
- Liberia
- Madagascar
- Malawi
- Mali
- Mozambique
- Niger
- Nigeria
| - Principe
- Rwanda
- Sao Tome
- Senegal
- Sierra Leone
- Somalia
- Sudan
- Swaziland
- Tanzania
- Togo
- Uganda
- Zaire
- Zambia
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- Ethiopia - Areas below 2,200 metres. No risk in Addis Ababa
- Namibia - The northern third of the country - November to June. All year long around the Kavango and Kunene rivers.
- South Africa - North east, low altitude areas of Mpumalanga and Northern Provinces, Northeast KwaZulu-Natal as far south as the Tugela river. Risk present in Kruger National Park.
- Zimbabwe - The Zambezi Valley.
| Doxycycline
OR
Mefloquine
OR
Malarone | Chloroquine
PLUS
Proguanil - (limited protection) |
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