Preventing Malaria: To Pill or Not to Pill
Let me preface this by saying that I am not a doctor. The information contained here is my experience and you should make your own decisions by discussing with your doctor.
Anti-Malarial drugs are a fairly contentious issue. While they certainly increase your odds of evading the disease, there is no guarantee. Many drugs come with a whole host of potentially nasty side effects (some of which I’ve heard people say are worse than getting the disease itself). Some argue that you shouldn’t bother with Anti-Malarials because if you get Malaria, you’ll be taking the exact same medication (just in a considerably higher dose).
On the other hand, many people take Anti-Malarials with no issues. The key is to do your own research. Do note that all Anti-Malarials do not work everywhere in the world. Mosquitos in different parts of the world have developed resistance to one or another Anti-Malarial. The World Health Organization maintains a great interactive map for travelers, telling you of the Malaria risk and drug resistance in the regions you will visit. A good guide book should also advise you as to specific areas of risk in a country. (For example, WHO says all of China’s Yunnan province is at risk, while Lonely Planet specifies that its actually just the border region with Laos and Vietnam).
As for me, on my last trip to Southeast Asia, I did use Anti-Malarials, though only for my initial time in Laos. I did a lot of research and chose Malarone (the brand name for Atovaquone & Proguanil), which is a newer drug that has the least side effects in comparison with the alternatives.It was fine for me and I had no reaction to it.
This time around, I did get myself some Malarone, again for my time in Laos. After my previous positive experience, I figured I didn’t have anything to lose and it was covered by my U.S. health insurance (which was nice, especially since they wouldn’t cover my Typhoid Fever vaccine).
Of course, the only 100% way to prevent Malaria is not get bitten! Wear light colors, keep exposed skin to a minimum (so wear long sleeves, pants and closed-toed shoes), and use an insect repellent with DEET. Note that mosquitos like to come out at night. (And yes, I realize that Southeast Asia can be extremely hot, so use an insect repellent liberally!)
Some people will advise you to bring along a mosquito net to sleep under that you’ve soaked in a repellent called Permethrin. I did for my last two trip to Southeast Asia, though I don’t think I will in the future as in a collective six months in Malaria and Dengue-prone areas, I only used the net once. Easier solution would be to spend a bit more and stay in a place where it wasn’t necessary!
Considering the lack of side effects I think I will continue to use Malarone on my travels to Malaria-prone areas, especially if it is covered by my health insurance! After all, what do I have to lose?
What are your thoughts? When you travel to Malaria-prone areas, do you take anti-malarials?