Malaria (or: how to avoid it)

We’re travelling to Thailand and Kenya, both of which have a widespread distribution of malaria. It’s prompted me to look into the anti-malarial effects of both the drugs recommended for prevention. These are doxycycline and malarone. Lariam (mefloquine) isn’t really recommended because of the trippy side effects and the development of chloroquine-resistant strains in some regions.

Doxy is just an anti-biotic (it’s used to treat various bacterial infections). However malaria (Plasmodium) is not a bacteria, it’s a protista, still a single cell creature but biologically very different. It seems that doxy has a side effect of reducing the cell division (ie reproduction) of Plasmodium. Unfortunately it does not completely stop it and, depending upon where the plasmodium is hiding in the body (liver or red blood cells), it might not always reach its target.

Malarone has two drugs (atovaquone and proguanil), both which *specifically* target the reproduction of Plasmodium, and are more effective in their results. The downside is that there are 4 species of Plasmodium, and malarone predominantly affects one (P. falciparum, the one that causes almost all fatalities often via cerebral haemorrhage). It seems to have effects against the other three, especially Vivax, but GlaxoSmithKline don’t seem to promote this.

As Kenya is a region with P. falciparum, we will be taking malarone. However Peru has a fair distribution of P. vivax, which is a slight concern.

Doxy has some weird side effects, the main two being photosensitivity (you can’t spend much time in the sun) and drowsiness/upset stomach.

On the cost front, malarone is £2 per day, doxy is 20p, so it’s a lot more expensive but we’d rather not take the risk.

Although the drugs help, we will also be taking all the usual precautions such as repellent, nets and long-sleeved clothing.

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