The World Health Organization (WHO) generally discourages travel with children to regions at risk of the “worst” form of malaria (ie caused by P. falciparum). Among other things, because malaria in children within a few hours can cause life-threatening complications, and malaria in infants may manifest itself initially atypically – without fever. Age below 5 years is a risk factor for the development of severe disease in case of malaria (P. falciparum). Statistically, 15-20% of cases of infected malaria in Europe and the US affect children.
If travel can not be avoided, it is very important to protect children against mosquitoes – repellents (if they do not lubricate children’s hands, because the repellent is not intended to be eaten), mosquito nets and chemoprophylaxis. Unfortunately, all this is not able to provide 100% protection against disease.
Despite this, it is worth knowing that about 2 million. (yes, yes – 2,000,000!) children travel annually to tropical regions and developing countries – countries where there is a risk of malaria. (Data based on – Centers for Diseases Control and Prevention, USA)
The basic principles of prophylaxis in children are:
A – Avareness = Awareness (risk of danger)
B – Bites of mosquito = Mosquito bites (how to prevent them)
C – Chemoprophylaxis = Chemoprophylaxis (anti-malaria drugs)
D – Diagnosis = Quick diagnosis (and taking the right treatment)
Chemoprophylaxis – antimalarial drugs available in Poland.
Take drugs or not take – that is the question. Discussion forums are full of conflicting opinions and comments in the style of “I never took and nothing happened”. The fact that nothing has happened over 100 trips does not mean that it will not happen. If the disease in the place we are going to go to, it’s just bad luck and the case may look serious. Therefore, everyone has to make a decision about taking medicines, remembering that in a critical situation they can save a life.
The World Health Organization recommends the combined use of mosquito protection measures and the prophylactic use of antimalarial medicines when traveling to most countries where this disease occurs.
Before you go, you need to find out which medicines will be effective in the place you are going to. There are many varieties of malaria and not every drug suits the type. For example, the border between Burma and Thailand and Thailand and Cambodia there is malaria resistant to many drugs, hence in this area Lariam is not recommended, but Malarone and Doxycycline works. In addition, the choice of drugs should always be guided by individual indications resulting from the age and health status of the outgoing person and other medicines taken by him.
Drugs not registered in Poland (eg Malarone Junior, Lariam) can be imported using the so-called procedures. “Target imports” that implement some of the pharmacies. An appropriate pharmacy can be indicated by a doctor from a tropical medicine clinic, most often it also helps to settle formal matters. You have to remember that it may take up to several weeks to bring the medicine back.Antimalarial prophylaxis in special situations:
Malaria is a very serious threat to the mother and her child, often the disease can lead to miscarriage or premature delivery or health complications in the newborn. Therefore, it is safer to avoid areas at risk of malaria during pregnancy.
Arechin and Paludrine can be used in the prevention of malaria during each pregnancy, Lariam is allowed in the second and third trimester of pregnancy. Doxycyclinum is contraindicated in pregnant women. Malarone – no research on its safety in this group of people.
The safety of using pregnant women’s repellents containing up to 20% of DEET has been proven
Mosquito nets soaked in permethrin are safe for pregnant women.
Some antimalarials used during pregnancy require the use of an increased dose of folic acid by the future mother.
An appropriate medication for a nursing mother is Arechin, Paludryna and Lariam. Doxycyclinum is not recommended. Malarone – his safety has not yet been investigated in this respect, according to British recommendations, it is permissible if there is no other alternative.
Taking drugs by my mother does not protect the child!
Antimalarial medicines bought in other countries
If for some reason we prefer to buy a given drug in Western Europe or in the USA, there is no problem – we only need to make sure that a Polish recipe is enough or a doctor’s prescription from a given country may be needed.
There is a popular theory that it is best to buy medicine in a place where malaria occurs, because then it is best suited to its treatment – GREAT MISTAKE ! The problem is that when buying drugs in Third World countries, most often we have no guarantee as to the composition of such a drug – most of them are counterfeits! A study conducted in Cambodia in 1999 revealed that 60% of medicines sold there as mefloquine (Lariam) contained other substances that were ineffective in the region or did not have any (!) Drug substance! On the other hand, other studies have confirmed that 90% of drugs sold in exotic countries as originals have nothing to do with their shape! They are completely ineffective!