Dr Ombeva,
I will be travelling with my four-year-old daughter to Kenya for a three-month holiday. We live in Europe. Kindly advise me on the best medicine to take to prevent malaria for me and my daughter.
Esther
Dear Esther,
Thank you for your question. There are two drugs for you to choose from. One is mefloquine and the other is atovaquone -proguanil (malarone). Mefloquin, which you and your daughter will have to take once weekly; starting with the week before you come to Kenya, then every week when you are here, and once every week for four weeks after you return. Your daughter takes half a tablet weekly and you take one tablet weekly.
The biggest challenge is nightmares, delusions and other neuropsychiatric side effects of mefloquin. Leading us to the second option, Malarone.
Malarone contains a combination of atovaquone and proguanil. You should not use Malarone if you are allergic to atovaquone or proguanil, or if you have kidney or liver disease. If you are taking Malarone to prevent malaria, start taking it 1 or 2 days before entering an area where malaria is common. Take the medication every day during your stay and for at least 7 days after you leave.
If you stop taking the medicine early for any reason, contact a healthcare professional about another form of malaria prevention. In addition to taking Malarone, use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could cause malaria. Your daughter will take one tablet for children daily while you will take one adult malarone tablet daily.
Another option is doxycycline, taken once daily starting one to two days before you travel here, then daily while here and daily for four weeks after you have gone back. However, it cannot be given to children, and also has more uncomfortable side effects than malarone.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up for the missed dose.
Malarone side effects may include severe or uncontrolled vomiting or diarrhea; fever, mouth sores; problems with speech, balance, or walking; severe skin rash; nausea, stomach pain, loss of appetite, dark urine, clay-coloured stools, jaundice (yellowing of the skin or eyes); easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.
- Dr Ombeva Malande is a paediatrics and child health expert.
