How is malaria treated?
There are clinical drug trials underway to develop an effective vaccine against the different forms of malaria. But until a vaccine is widely available, prevention is still the best form of protection against this disease. If you are traveling to a tropical country you should always take medicines to protect against malaria.

These medicines (antimalarials) do not provide true protection against malaria as they do not actually prevent the parasites from entering the body. Instead, they work by suppressing the development of the parasites in the red blood cells. Some antimalarials may also inhibit the development of parasites in the liver.

Most courses of antimalarials should be started 1–2 weeks before entering an infected area, continued while there, and for 4 weeks after leaving. Some treatments may be started as late as 1 or 2 days before entering an infected area and continued for only 1 week after returning. Always carefully read the instructions in the prescribing information that accompanies the medicine. Unfortunately, there are now areas where malaria has become resistant to certain drugs and alternative drugs need to be used. No drug regimen is completely effective against this disease and people can develop malaria even after taking the drugs. Antimalarials will be prescribed according to the areas that will be visited. Your doctor or pharmacist should double-check to verify which antimalarials are recommended for the region to which you are traveling.

Antimalarials are often prescribed in combination. The most commonly prescribed combination is atovaquone  and proguanil (Malarone). Other single therapies include mefloquine (Lariam), doxycycline (Vibra-Tabs, Vibramycin), chloroquine (Aralen), and hydroxychloroquine (Plaquenil). Some antimalarials are taken weekly, and others are taken daily. Side effects can be a problem with some antimalarials, but fear of these should not prevent you from taking them. Starting treatment at least a week before traveling should help to identify any problems before departure, giving an opportunity for alternatives to be considered.

If infection with malaria does occur, a number of medicines can be prescribed to treat it, including some of those used for prevention. In emergencies, some drugs may also be given by injection. Drugs prescribed for treatment may include artemether/lumefantrine (Coartem), atovaquone/proguanil, chloroquine, hydroxychloroquine, mefloquine, and quinine (Qualaquin). Delaying treatment can have serious consequences.

How can malaria be prevented?
To reduce the risk of being bitten by an infected mosquito

  • Apply insect repellent to exposed skin, particularly at dusk and overnight. Mosquito nets, especially those impregnated with insecticide are very helpful, particularly in high-risk areas. Air conditioning and mesh protection at windows may help to prevent insects from entering a bedroom at night.
  • Always take the correct dose of antimalarial medication and continue the course for the recommended time after leaving an area of risk.
  • If infection with malaria is suspected, a blood test to confirm the presence and type of malaria is necessary as soon as possible so that treatment can be started right away.

Further information
Centers for Disease Control and Prevention: www.cdc.gov/MALARIA/
World Health Organization: who.int/topics/malaria/en/

Last Reviewed: June 2013