Malaria Prevention Strategies Should Be Individualized

Specialists need to individualize malaria prevention strategies for long-term travelers

TUESDAY, Nov. 7 (HealthDay News) -- Until a consensus on guidelines is reached, individually tailored strategies are needed to help prevent malaria among long-term travelers, according to a literature review published in the Nov. 8 issue of the Journal of the American Medical Association.

Lin H. Chen, M.D., of Mount Auburn Hospital in Cambridge, Mass., and colleagues conducted a literature review of all studies concerning the risks of malaria transmission through July 2006. They found that long-term travelers (those traveling six months or longer) are at higher risk of developing malaria than short-term travelers, adhere poorly to continuous chemoprophylaxis regimens and underuse personal protection methods such as staying inside from dusk to dawn, wearing barrier clothing and spraying residences with insecticide.

The various strategies used for chemoprophylaxis have benefits and drawbacks, the authors state. Relapses of vivax malaria are not prevented with any of the current first-line chemoprophylaxis regimens because they don't eliminate liver-stage parasites. Presumptive antirelapse therapy should be considered if a traveler has been intensively exposed to P. vivax. Moreover, travelers should consider evacuation insurance and carry their own medication, as counterfeit drugs are rampant in developing countries.

"General guidelines are desirable, but recommendations for malaria prevention in long-term travelers must be individualized and should be provided by travel medicine specialists," the authors conclude.

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