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Staying Healthy on the Road Medical info, e.g. malaria, vaccinations, travel medical tips, medical insurance, where to find a doctor.
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Old 19 Aug 2003
tam tam is offline
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Possible duration for malaria protection?

Hello all,
Sorry about this but I have looked around the site and not found answers to this question.
I am currently in Guatemala and am planning to go down to Argentina. So far I have taken no medicine for prevention of this nasty disease, I have Doxycycline tablets but I wanted to save them for the Amazon.
As I am planning to go down some of the malaria coast here I was wondering if anyone knows about the length of time you can keep taking the drugs for?
What is the most effective way for long term (up to six months) protection?
Thanks, Trys.
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Old 24 Aug 2003
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Join Date: Jul 1999
Location: Canada
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Hi Trys, and welcome to the HUBB!

There isn't a lot of information on the topic of long-term use of malaria prophylaxis, but there have been some studies on expats. Health Canada's advice:

"At present, there is no evidence that long-term use of therapies currently recommended for short-stay travellers have significant adverse reactions. Doxycycline may be an exception, as studies have been confined to short-term travellers and persons using tetracyclines (at lower dosage) for skin therapy.

In general, guidelines for the prevention of malaria in long-term travellers or expatriates should not deviate significantly from standard recommendations for the short-term traveller."
Worth noting is that long-term would be considered 6-12 months or more. For up to 6 months, the suggestion is to follow the same regimen which you would follow for short-term use.

When you start and stop the pills dependson the actual drug you are taking. The following guidelines are from the US Center for Disease Control website. Starting prophylaxis:

<font face="" size="2">"Malaria chemoprophylaxis with mefloquine or chloroquine should begin 1–2 weeks before travel to malarious areas; prophylaxis with doxycycline and atovaquone/proguanil can begin 1–2 days before travel. Beginning the drug before travel allows the antimalarial to be in the blood before exposure to the malaria parasite. Chemoprophylaxis can be started earlier if there are particular concerns about tolerating one of the medications. Starting the medication 3–4 weeks in advance allows potential adverse events to occur prior to travel. Should unacceptable side effects develop, there would be a greater window of opportunity to change the medication before the traveler’s departure."</font>
Ending prophylaxis:
<font face="" size="2">"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). "</font>
Hope this helps. Of course you know that avoiding being bitten is the best prevention, and you shouldn't rely on the malaria prophylaxis. So don't forget your mosquito repellent and long sleeves whenever the mossies are biting.

Susan Johnson

"It matters not what goal you seek
Its secret here reposes:
You've got to dig from week to week
To get Results or Roses."
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'One world, two wheels'
Susan Johnson

Inspiring, Informing and Connecting travellers since 1997
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Old 1 Sep 2003
tam tam is offline
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Thanks Susan,
I'll see how it goes with the Doxycycline over the comming months.
Cheers, Trys.
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