Ask the experts
I returned from a mission trip to Africa last week and I started developing flu-like symptoms. My doctor inquired about my recent travel. When she heard about my travel, she immediately ordered a blood test, which came back positive for malaria. I'm starting treatment now with chloroquine, but I don't know that that's the best treatment, considering most U.S. doctors don't usually deal with malaria. What is the best medicine for malaria treatment?
Besides supportive care, the medical team needs to decide on the appropriate antimalarial drug(s) to treat malaria. The choice will depend on several factors, including
- the specific species of parasite identified,
- the severity of symptoms, and
- determination of drug resistance based on the geographic area where the patient traveled.
- Physicians will administer the medication in pill form or as an intravenous antimalarial depending on above factors.
The most commonly used medications are
- chloroquine (Aralen),
- doxycycline (Vibramycin, Oracea, Adoxa, Atridox),
- quinine (Qualaquin),
- mefloquine (Lariam),
- atovaquone/proguanil (Malarone),
- artemether/lumefantrine (Coartem), and
- primaquine phosphate (Primaquine).
Of course, the best medicine is prevention. The prevention of malaria includes several steps.
First, evaluate if malaria is a concern in the area of travel (CDC malaria information by country table). This table will also indicate which medication to take as chemo-prophylaxis.
If chemo-prophylaxis is recommended, discuss the recommended medications with a health care professional to determine if they are appropriate. Take into consideration any medical conditions, drug interactions with current medication taken on a continual basis, as well as side effects of the recommended medications.
No medication is 100% effective, and therefore the prevention of mosquito bites is of paramount importance. These preventive measures should include the following:
- Sleeping under bed nets: These should cover all of the bed down to the floor. These nets are most effective when treated with an insecticide.
- Clothing: Clothing that covers most of the exposed skin and shoes that are closed can reduce the risk of bites. Tuck in all clothing, and pants should be tucked into socks to avoid exposure around the ankles. In addition, treating clothes with insecticides can prevent bites even further.
- Apply insect repellent to all exposed skin.
For more information, read our full medical article on malaria.
Khuu, Diana, Mark L. Eberhard, Benjamin N. Bristow, Marjan Javanbakht, Lawrence R. Ash, Shira C. Shafir, and Frank J. Sorvillo. "Malaria-Related Hospitalizations in the United States, 2000-2014." The American Journal of Tropical Medicine and Hygiene 97.1 July 2017: 213-221.
Switzerland. World Health Organization. "Malaria." April 2016. <http://www.who.int/mediacentre/factsheets/fs094/en/>.
Tintinalli, Judith E., ed. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York: McGraw-Hill, 2011: 1056-1062.
United States. Centers for Disease Control and Prevention. "Malaria." June 16, 2018. <https://www.cdc.gov/parasites/malaria/index.html>.