Update on prevention of malaria for travelers
H. O. Lobel and P. E. Kozarsky
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. hol1@cdc.gov
Individuals from industrialized nations frequently travel to countries with
malaria, so health care providers need to be familiar with current
recommendations for prevention of malaria. Changes in drug susceptibility
of malaria parasites and evolving knowledge of how well drugs are tolerated
necessitate periodic review of guidelines for prophylaxis of malaria,
especially of chloroquine-resistant Plasmodium falciparum malaria.
Mefloquine is the drug of choice for chemoprophylaxis for most travelers,
with doxycycline and chloroquine being less effective alternatives.
Mefloquine is well tolerated at prophylactic dosages, but anecdotal reports
have raised concerns about its adverse effects. Resistance to this drug has
emerged in parts of Southeast Asia and may spread to other regions of the
world. The major disadvantages of doxycycline are the need for daily
dosing, its contraindication for young children and pregnant women, and its
adverse effects. Chloroquine is effective for prophylaxis only in Central
America, the Caribbean, and parts of the Middle East. Few new drugs will be
available in the near future because of reduced funding for antimalarial
drug research and development; therefore, the usefulness of currently
available drugs needs to be prolonged by rational use. Increased efforts
should be made to ensure that alternative drugs will be available for
prevention of malaria.
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ABSTRACT
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ABSTRACT
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