Infection malaria Flashcards
MALARIA
BITE PROTECTION ADVICE (not absolute)?
MOSQUITO NETS IMPREGNATED W/ PERMETHRIN
DEET 20-50% protection (50 best)
DEET counselling points?
for anyone > 2months old
Avoid ingestion-> wash hands before eating, foul smell
Pregnancy & breastfeeding fine (wash breast before feeding)
Apply DEET AFTER sunscreen
Note: DEET reduces SPF of sunscreen-> use high SPF lotion
MALARIA PROPHYLAXIS TREATMENT
MALORONE (atovaquone w/ proguanil)
HOW LONG BEFORE TRAVEL?
DOSE?
AFTER TRAVEL?
MAX. USE?
BEFORE TRAVEL? 1-2 days
DOSE? 1 OD
AFTER TRAVEL? 1 WEEKLY
MAX. USE? 1 YEAR
MALARIA PROPHYLAXIS TREATMENT
CHLOROQUINE
HOW LONG BEFORE TRAVEL?
DOSE?
AFTER TRAVEL?
MAX. USE?
BEFORE TRAVEL? 1 WEEK
DOSE? 1 WEEKLY
AFTER TRAVEL? 4 WEEKLY
MAX. USE? LONG-TERM
MALARIA PROPHYLAXIS TREATMENT
MEFLOQUINE
HOW LONG BEFORE TRAVEL?
DOSE?
AFTER TRAVEL?
MAX. USE?
BEFORE TRAVEL? 2-3 WEEKS
DOSE? 1 WEEKLY
AFTER TRAVEL? 4 WEEKS
MAX. USE? 1 YEAR
MALARIA PROPHYLAXIS TREATMENT
DOXYCYCLINE
HOW LONG BEFORE TRAVEL?
DOSE?
AFTER TRAVEL?
MAX. USE?
BEFORE TRAVEL? 1-2 DAYS
DOSE? 1 OD
AFTER TRAVEL? 4 WEEKS
MAX. USE? 2 YEARS
MALARIA PROPHYLAXIS TREATMENT
Which one is long-term?
Officer PC Long
(Proguanil)
Chloroquine
Any illness that occurs within 1 year and especially within X months of return might be malaria–> see doctor asap!
3 months
which 2 pt groups are at high risk of malaria
asplenia: no spleen
pregnancy
in pregnancy, avoid travelling to malarious regions.
which anti malarial can be given?
chloroquine
but give high dose folic acid too: 5mg, due to neural tube defect
5mg POM
400mcg OTC
MALARIA- MEDICATION GROUPS
EPILEPTIC PATIENTS SHOULD AVOID which 2 meds?
CHOLORQUINE/MEFLOQUINE- reduces seizure threshold
(quine - think quinolones and avoid in epilepsy too)
MALARIA- MEDICATION GROUPS
WARFARIN when to begin treatment?
2-3 weeks before departure
when to measure inr for pt on warfarin?
Measure INR:
Before anti-malaria &
7 days after starting course &
After completing course
Prolonged stays? check INR regularly
*should be stable before you fly
MALARIA- MEDICATION CAUTIONS
MEFLOQUINE?
History of psychiatric disorders. develop? STOP+seek med attention
History of convulsions
MALARIA- MEDICATION CAUTIONS
CHLOROQUINE?
History of convulsions
Can be retinotoxic
(blurred vision)
MALARIA- MEDICATION CAUTIONS
PROGUANIL?
RENAL IMPAIRMENT-> reduce dose
MALARIA- MEDICATION CAUTIONS
DOXYCYCLINE?
Avoid exposure to sunlight
difficult if going to hot sunny country
MALARIA- EMERGENCY STANDBY TREATMENT
When to carry standby treatment? what is this?
travelling to remote areas do this if likely to be >24hrs away from medical care
self med should be avoided if med help accessible
example of standby tx
azithromycin for travellers diarrhea going somehwhere where no med attention access
what written instructions should be provided to traveler in standby tx
Seek urgent medical attention if fever (38°C or more) develops 7 days (or more) after arriving in a malarious area
Self-treatment is indicated if medical help is not available within 24 hours of fever onset
DOXYCYCLINE SIDE-EFFECTS?
PHOTOSENSITIVITY
TEETH DISCOLOURATION
HEADACHE
DIARRHOEA
NOT CONSTIPATION!
