[Malaria chemoprophylaxis].
Malaria is a serious infection, and prevention traditionally relies on chemoprophylaxis during and after exposure. The risk of side effects from chemoprophylaxis needs to be balanced against the risk of infection, and there has been conducted only one prospective, double-blind study comparing the suspected side effects of mefloquine (Lariam), atovaquone/proguanil (Malarone), doxycycline and chloroquine/proguanil. Therefore the current recommendations are based on descriptive studies and case reports. There is a lack of data on the risk of infection in travellers, and the national statistics on the number of imported cases are not very useful as long as the total number of travellers at risk is not known. The risk to travellers is therefore estimated from data on malaria in the indigenous population, while the risk for travellers is expected to be lower. Atovaquone/proguanil has been registered in Europe for travels of up to four weeks, but in the United States there is no upper limit for the duration of use. It is not possible to prescribe efficient prophylaxis to pregnant women in the first trimester or infants below 11 kilograms of body weight travelling to tropical Africa.
Petersen
Jørgen Eskild
JE
Arhus Universitetshospital, Skejby Sygehus, Infektionsmedicinsk Afdeling, Arhus N. epf@sks.aaa.dk
D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D053626:Atovaquone; D002738:Chloroquine / Q000008:administration & dosage; D000075202:Contraindications; D004318:Doxycycline / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000517:prevention & control*; D015767:Mefloquine / Q000008:administration & dosage; D009285:Naphthoquinones / Q000008:administration & dosage; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D002727:Proguanil / Q000008:administration & dosage; D018570:Risk Assessment; D014195:Travel
D000962:Antimalarials; D004338:Drug Combinations; D009285:Naphthoquinones; C109496:atovaquone, proguanil drug combination; D002738:Chloroquine; D004318:Doxycycline; D002727:Proguanil; D015767:Mefloquine; D053626:Atovaquone