The information that you provide is covered by the same patient-doctor confidentiality as in a normal face to face consultation.
Please consider your responses and answer honestly and clearly. The questions will be based on:
- The treatment you are requesting
- Your health
- Your medical history
If medically suitable, you will receive your paper prescription through the post usually within 2 business days after approval.
We refund the full amount if our Doctors cannot treat you.
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What is Malaria?
Malaria is an infection caused by tiny parasites called Plasmodium which get access to the bloodstream via the bite of certain mosquitos. They are injected into the skin in the saliva of the insect.
It is a disease of the tropical and sub-tropical areas of the world and is very widespread.
Malaria currently kills many hundreds of thousands especially children in developing countries every year.
Currently there are no vaccines available for malaria, but you can protect yourself against this potentially deadly disease.
Everyone gets bitten by insects but some persons react more to the insect bite and this causes the bite to be inflamed. Others do not have any reaction to the bite and so can think that they do not get bitten. Do not be fooled - everyone gets bitten!
Remember that taking the anti-malarial tablets does not guarantee that you will not catch malaria. So using various bite avoidance measures is as important as taking the medicine.
- Avoid mosquito bites, especially after sunset. If you are out at night wear long-sleeved clothing and long trousers.
- Mosquitoes can bite through thin clothing, so spray an insecticide (such as Permethrin - this is used in many insecticide sprays) on the clothing but AVOID spraying on the skin.
- Use insect repellent (such as one that contains DEET) on any exposed areas of skin.
- Spraying insecticides in the room (pay particular attention to spraying areas behind bedside lockers and other bedroom furniture), burning pyrethroid coils and heating insecticide impregnated tablets all help to control mosquitoes.
- If sleeping in a room which is air conditioned, remember to keep the windows closed!
- If sleeping in an unscreened room, or outdoors, then using a mosquito net impregnated with insecticide is essential to minimise bites while asleep.
- The advice that Vitamin B, Garlic and ultrasound devices prevent bites is false! They offer no protection!
Using these bite avoidance measures will minimise the risk of malaria mosquito bites. But they will also minimise the risk of bites from other strains of mosquito insects which spread other serious infections including dengue, yellow fever and Japanese encephalitis (all of which are potentially fatal diseases!)
Being aware that despite following these directions, malaria can still occur up to a year after leaving the malaria zone!
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Which is the "Best" Anti-Malaria Medication to Take
There are four types of anti malarial medication available. These are:
- Malarone, generic name Atovaquone/Proguanil,
- Vibramycin™, generic name Doxycycline,
- Lariam™, generic name Mefloquine,
- Nivaquine™, generic name Chloroquine and Avloclor™, generic name Proguanil.
Which one you use depends on where you plan to travel to, and for how long, and whether you have used one of the medications previously.
However for various reasons the Malarone medication is the most frequently prescribed. This is because despite the need to take this tablet on a daily basis while in the malaria zone, it must be taken for only another seven days on exiting the malaria area. (In contrast the other medications must be taken for a further 28 days on leaving the malaria zone.)
Malarone generally is well tolerated by most individuals and the most common side effect is mild nausea but this is minimised by taking the tablet with a meal.
By contrast both Doxycycline and Mefloquine have several problematical aspects. Taking Mefloquine (Lariam™) is frequently associated with vivid dreams and nightmares and occasionally can progress to causing anxiety and low mood. Very rarely it has been reported to cause an acute mental breakdown. However, if you have taken Lariam™ previously and had no problems with this, then you may wish to use this medication provided it is the appropriate anti-malarial for the destination you are travelling to.The one advantage of Lariam is that it is taken on a once a week basis rather than on a daily basis like Malarone or Doxycycline.
There are several problematical aspects with taking Doxycycline. Firstly as it is an antibiotic which will be taken for at least a month or more, it can cause an outbreak of vaginal thrush which can be very uncomfortable in a warm climate. In addition, if a woman is on the oral contraceptive pill, the Doxycycline can interfere with the reliability of the pill. Finally in up to 10% of persons who take this medication, there is a chance of developing an itchy skin rash due to an interaction between the doxycycline and the effect of the sun on the skin.
The use of Nivaquine™ and Avloclor™ are very limited now as the malarial parasite has developed resistance to these compounds and their use is limited now to areas of Central America.
For these reasons, it is easy to understand why Malarone tends to be the most commonly prescribed anti-malarial medication.
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Specific Instructions for Taking Anti-Malarial Medications
- Remember to start the medication BEFORE you enter the malaria area.
- Take the medication as directed (either daily or as with Lariam weekly).
- Take the medication with food to minimise any nausea.
- Remember to continue with the medication AFTER leaving the malaria zone for a week in the case of Malarone and a month in the case of all of the other medications.
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