Infection - Malaria

Question 1

is malaria bite protection absolute?

Answer 1

not absolute

Question 2

what is malaria bite protection?

Answer 2

• mosquito net impregnated permethrin
• diethyltoluamide (DEET) 20-50% (50% longer protection)

Question 3

malaria bite protection and ingestion

Answer 3

avoid ingestion wash hands

Question 4

when is malaria bite protection suitable?

Answer 4

• pregnancy + BF
• suitable for anyone over 2 months

Question 5

malaria bite protection and SPF

which one to apply first and why

Answer 5

• apply SPF then DEET
• deet reduces SPF of sunscreen

Question 6

malaria prophylaxis tx

Answer 6

• malarone + atorvaquone + proguanil
• chloroquine
• proguanil
• mefloquine
• doxycycline

Question 7

if illness occurs within 1 year of tx what is it?

Answer 7

especially 3 month of return might still be malaria

Question 8

before travel, dose, after travel and max use?

dose and duration of malarone + atorvaquone + proguanil

Answer 8

• before travel - 1-2DY
• dosage - 1OD
• after travel - 1WK
• max use - 1YR

Question 9

before travel, dose, after travel and max use?

dose and duration of chloroquine

Answer 9

• before travel -1WK
• dosage - OW
• after travel -4WK
• max use -LONG TERM

Question 10

before travel, dose, after travel and max use?

dose and duration of progunanil

Answer 10

• before travel -1WK
• dosage -1OD
• after travel -4WK
• max use -LONG TERM

Question 11

before travel, dose, after travel and max use?

dose and duration of mefloquine

Answer 11

• before travel -2-3WK
• dosage -OW
• after travel -4WK
• max use -1YR

Question 12

before travel, dose, after travel and max use?

dose and duration of doxycycline

Answer 12

• before travel -1-2DY
• dosage -1OD
• after travel -4WK
• max use -2YR

Question 13

malaria pt groups

Answer 13

• asplenia
• pregnancy

Question 14

malaria pt groups

asplenia and malaria

Answer 14

high risk of malaria

Question 15

malaria pt groups

pregnancy and malaria

Answer 15

• avoid travelling to regions with malaria
• can give chloroquine + proguanil + 5mg folic acid (neural tube defect risk)

Question 16

malaria medication groups

Answer 16

• epilespy
• warfarin

Question 17

malaria medication groups

which malarial drugs to avioid in epilepsy

Answer 17

avoid chloroquine + mefoloquine

Question 18

malaria medication groups

warfarin and malaria

Answer 18

• start tx 2-3wk before travel
  –>INR stable before travel
  –>INR measured before antimalarials, 7DY after starting + after completing
  –>prolonged stay check INR regularly

Question 19

antimalarial caution

mefloquine caution

Answer 19

• history of psychiatric disorders if develops STOP
• history convulsions

Question 20

antimalarial caution

chloroquine caution

Answer 20

• history od convulsion
• can be retinotoxic

Question 21

antimalarial caution

progunail caution

Answer 21

renal impairement - reduce dose

Question 22

antimalarial caution

doxycycline caution

Answer 22

avoid exposure to sunlight

Question 23

who should receive malaria standby tx

Answer 23

travellers visiting remote areas should carry emergency standby tx if they are likely to be more than 24hr from medical care

Question 24

who shouldn’t receive malaria standby tx

Answer 24

self medication should be avoided in travellers if medical help is accesible

Question 25

what are the written instructions for travellers with standby tx

Answer 25

• seek urgent medical attention if fever (38+) develops 7+ days after arriving in a malarious area
• self-tx if medical help is not available within 24hr of fever onset