Holiday Health OTC - Malaria

Question 1

What are the main features of Malaria?

Answer 1

Parasitic disease spread by female anopheles mosquito.
4 species of protozoan plasmodium produces malaria in humans: P. Vivas/ovale/malariae/ falciparum (most virulent)
Non specific symptoms (misdiagnosis = high risk)

Question 2

What are the symptoms of malaria?

Answer 2

Fever/sweats/chills
Malaise (vague discomfort)
Myalgia (muscle pain, tenderness)
N+V
Headache
Diarrhoea
Cough
Jaundice

Question 3

Explain the treatment of malaria.

Answer 3

Px travelling for prolonged periods should carry standby tx.
If they’re likely to be more than 24 hrs away from medical are.
Used if fever > 38 degrees develops more than a week after arriving in high risk malaria area.
Best to use the same drug in chemoprophylaxis for tx.
Must have clear written instructions on dose and use.

Question 4

Explain the process of bite avoidance.

Answer 4

Awareness of risk (Travel health pro)
Bite prevention
Chemoprophylaxis
Prompt Diagnosis and tx

Always check for updated guidance on chemoprophylaxis of malaria.

Question 5

Explain the process of bite prevention.

Answer 5

Insect repellants
Long sleeved shirts, socks/ trousers, particularly at dawn and dusk.
Aides Aegypti mosquito active during the day - responsible for yellow fever/ Zia virus and dengue fever transmission.
Mosquito nets
Keep doors and windows closed during evening and night
Mosquito plug in dispensers.

Question 6

What is DEET?

Answer 6

Diethyltolbutamide
Duration of protection: 1-3 hrs (20%), up to 6 hrs (30/5) and up to 12 hrs (50%)
Apply any sunscreen first - DEET reduces efficacy of sunscreen.
DEET not recommended for < 2 months old.
Patch test first
DEET application can damage some plastic watch straps and glasses.

Question 7

What px factors do you need to consider for Malaria chemoprophylaxis? (6)

Answer 7

Age and weight everyone travelling
Underlying conditions
Allergies
Current Rx medications
Have they used an anti malarial before?
Area visiting and how long they’re staying for?

Question 8

What are the chemoprophylaxis options for Malaria? (3)

Answer 8

Chloroquine (Avloclor) and Proguanil (Paludrine) = limited use due to widespread resistance.
Doxycycline, Mefloquin (Lariam) = POM and can only be supplied as part of PGD or private Rx.
Atovaquone / Proguanil (Malarone) = most effective i.e. Maloff Protect.

Question 9

When would you consider vaccinations for Malaria prevention? (1)

Answer 9

Depends on destination and holiday.