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Bug Zappers
A guide to picking
the right antimalarial prophylactic
By Dan Oko
 The
rules for avoiding malaria are deceptively simple: Prevent mosquito
bites, and avoid the disease. So it’s best to stay in
air-conditioned hotels to lower the chance of being bitten at night,
and wear long sleeves and pants to cover your skin. In the tropics,
that’s not always convenient or comfortable. So in addition to
stocking up on deet-based bug juice and traveling with a bed net to
keep those bloodsuckers at bay, having the right antimalarial drugs
on hand is crucial.
Chloroquine
Brand name
Aralen
Prescribed for Travelers to Central America and the
Caribbean; not recommended for Africa or Southeast Asia
Take it
Weekly. Start one to two weeks prior to departure, and continue for
four weeks after returning.
Side effects Upset stomach,
headaches, insomnia, and itching
Mefloquine
Brand name
Lariam
Prescribed for Travelers headed to eastern and southern
Africa, the entire Indian subcontinent, and any other regions where
chloroquine resistant malaria is found. Avoid both chloroquine and
mefloquine in Thailand, Vietnam, and Cambodia.
Take it Weekly.
Start one to two weeks prior to departure, and continue for four
weeks after returning.
Side effects Psychological problems,
including nightmares, depression, and hallucinations. Take a course
well ahead of your trip to identify any issues before you
go.
Doxycycline
Brand name Numerous, with plenty of
generics as well
Prescribed for Travelers to zones with
chloroquine- and mefloquine-resistant malaria who are looking for a
less expensive yet still effective alternative to Malarone.
Doxycycline can also be taken as an antibiotic to treat other
illnesses.
Take it Daily. Start one to two days prior to
departure, and continue for four weeks after returning.
Side
effects Nausea and photosensitivity. Lather up with a serious UVA
sunscreen, or anticipate a bad sunburn.
Atovaquone/Proguanil
Brand
name Malarone
Prescribed for This is an expensive combo drug that
is best for travelers to areas where malaria strains resistant to
chloroquine are abundant, such as West Africa, South America,
Southeast Asia, and Oceania.
Take it Daily. Start one to two days
prior to departure, and continue for a week after returning.
Side
effects Abdominal pain and nausea; always take Malarone with meals.
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