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Your guide to malaria protection
Malaria prevention has always been a consideration for expats and travellers alike, but there have been reports of a treatment-resistant strain of the disease gradually sweeping through Southeast Asia.
First encountered in Cambodia in 2007, this so-called ‘super’ malaria – which is resistant to typical antimalarial treatment – has now been recorded in Thailand, Laos and, most recently, southern Vietnam, with over 19,000 cases reported in 2015.
Fears are that if the drug-resistant strain spreads to Africa, where the 92% of malaria deaths occur, it could worsen an already major crisis there.
Who is at risk?
According to the World Health Organisation (WHO), 1.5 million people in Southeast Asia are infected with malaria every year, with 620 reported deaths in 2015.
In a joint letter to The Lancet Infectious Diseases, Professor Arjen Dondrop and his research team at the Oxford Tropical Medicine Research Unit in Bangkok, highlighted increasing numbers of failures in malaria treatment, with the figure bordering on 60% in Cambodia.
With no vaccine available for malaria, taking measures to reduce the risk of contracting it continues to be the number one rule to follow in affected areas.
Malaria – the statistics
In 2015, 91 countries and areas had ongoing malaria transmission
Africa is home to 90% of malaria cases and 92% of malaria deaths, followed by Southeast Asia (7%) and the Eastern Mediterranean region (2%)
Three deaths were recorded in Vietnam from super malaria in 2015, with more than 19,000 cases reported
What is super malaria?
Malaria is caused by a parasite that is transmitted through the bites of certain species of mosquitoes. It can be fatal if left untreated, especially in children.
The super malaria strain of the disease is so called because of its resistance to the typical antimalarial drugs, which treat and prevent the effects of malaria; these include fever, organ problems, and, in the most severe cases, death.
What treatments are there?
The usual treatment for malaria includes using a combination of two powerful anti-malarial drugs –artemisinin and piperaquine. However, the super malaria strain has become resistant to both these drugs.
While the WHO continues to advocate the use of antimalarial tablets in recommended regions, it admits this resistance is making any necessary treatment more challenging – and increasing the need for close monitoring and prevention.
Before you travel
If you are travelling to an affected region, your doctor or health professional may advise carrying some emergency medication for malaria. Make sure you fully understand and record the correct dosages, as well as any side effects to look out for.
What can I do?
- Taking antimalarial tablets – Always visit an approved city-based clinic or hospital for a thorough assessment. Provide healthcare professionals with as much detail as you can about any locations you will be based in/or plan to visit.
- Using a powerful insect repellent – Spend some time researching the products available to you and what the ingredients will offer. Don’t assume it’s a one-size-fits-all scenario, as some compounds shouldn’t be used if you are pregnant or children under a certain age.
Research from the US-based Consumer Reports Buying Guide suggests that Deet, Picardin and Oil of Lemon Eucalyptus offer the most protection – although it warns that in high concentrations (Deet and Eucalyptus over 30% and Picaridin over 20%) they can cause skin problems and such concentrations are not necessarily more effective.
Researchers found the following levels to be highly effective, noting that sprays are more effective than creams:
Deet –15-30% concentration
Picaridin – 20% concentration
Oil of Lemon Eucalyptus – 30% concentration
- Keeping your arms and legs covered – Mosquitoes tend to be more active at dawn, dusk and overnight, so apply repellent and wear long-sleeved tops and long skirts or trousers. Opt for loose-fitting garments, as insects can still bite through tighter clothing. Mosquitoes are naturally drawn to darker shades, so wearing lighter colours should also help.
- Closing doors and windows – Use air conditioning when available, so that you can keep windows and doors closed. Pedestal fans and screens will also decrease mosquito activity.
- Using bed nets – Organisations working to reduce malaria risk around the world have achieved success using long-lasting insecticidal nets (LLINs). These nets, treated with a low level of insecticide, provide a physical and chemical barrier to mosquitos overnight, when bites often take place. There are many different types, so it helps to research the net you need in advance.
- Staying cool – A higher body temperature can attract unwelcome visitors, as can perfume and other scented products worn on the body.
How to spot malaria symptoms
sweats and chills
Malaria can begin to show just days after an infected mosquito bite, but commonly takes around 10 days to three weeks. In most cases, the illness starts with a fever, so always seek medical attention at the first sign of one.
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