Malaria 1984. Part I. Malaria prophylaxis

Abstract

Guidelines are presented to assist the prescriber in arriving at a logical and up-to-date approach to the chemoprophylaxis of malaria, particularly for residents of and visitors to Africa. Areas of controversy are highlighted, with a critical but simplified practical approach being taken to a complex subject. The importance of a history of recent travel in a patient presenting with an unexplained fever is stressed. A series of tables listing geographical areas where chloroquine- and other drug-resistant Plasmodium falciparum is found is provided as an aid to the logical selection of prophylactic agents for the traveller. For convenience, tables of dosages for all ages are given. Similarly, an algorithm is provided to facilitate decision-making in drug usage. The controversial topic of malaria prophylaxis in pregnancy is discussed in the light of published information. Although the prophylaxis of possible drug-resistant malaria has been alluded to in Part I, in Part II of this series the treatment and theoretical aspects of resistant malaria will be covered with a view to providing guidelines for those faced with this ever-increasing problem.