You are travelling to an area with a high risk of malaria, which is why malaria tablets are
advised. Besides taking these tablets, it is important to keep yourself well
protect against mosquito bites. Find out more about malaria, how to
occur and how to use the tablets.
What is malaria?
Malaria is an infectious disease caused by a malaria parasite. This parasite
enters the body through a mosquito bite. Mosquitoes that transmit malaria bite between
sunset and sunrise.
This disease can be very similar to flu. Features include: fever (> 38.5ºC), fatigue, headache
and muscle pain. You may also get diarrhoea, vomit or cough, or breathe harder
(are you short of breath). The fever is not always high and it does not always make you shiver. Certain
groups of travellers such as young children (<5 years) and pregnant women are at increased risk of
severe malaria.
There are six different forms of malaria:
- The most dangerous form is malaria tropica. You get that from the Plasmodium falciparum
parasite. You can die from that in a matter of days. In general, malaria is
tropica can be treated well if treatment is started in time. The disease should then
do get recognised in time. - Three other forms of malaria (caused by the parasites Plasmodium vivax,
Plasmodium ovale and Plasmodium malariae) are less dangerous. The characteristics are
the same, but people rarely die from this. - Finally, malaria can be caused by the parasites Plasmodium knowlesi and
Plasmodium brasilianum. These are forms that make macaques (a type of monkey) especially sick.
Sometimes these species are also found in humans. To an infection with Plasmodium
knowlesi you can die.
Where does malaria occur?
Malaria occurs in areas of South and Central America, Africa and Asia. In sub-Saharan
Africa and parts of Asia and South America have the highest risk of contracting malaria. At
www.lcr.nl find on the 'Advice by Country' page where you are at risk of contracting malaria.
Over time, malaria may become more or less prevalent in an area. It is important
to check with a traveller's advisor before each trip.
Note: For individual advice, always visit a traveller's advisor. The advice may
vary from person to person. This may be due to medication use, for example,
pregnancy or your health condition.
PROTECTION AGAINST MOSQUITO BITES
The following anti-mosquito measures apply to anyone staying in a malaria area
from dusk to dawn. During the day, it is also important to protect yourself from
mosquitoes that can transmit other diseases:
● Wear well-covering clothing: long sleeves, long trousers, closed shoes with
socks;
● On uncovered body parts, use insect repellent containing DEET, see
For more information on dosages, read the leaflet 'Mosquito repellent when travelling';
● Make sure your bedroom is mosquito-free or sleep under a tightly sealed and
impregnated mosquito net (mosquito net);
● An air-conditioned enclosed room also helps protect against mosquitoes.
ANTIMALARIAL DRUGS (CHEMOPROPHYLAXIS)
There are four different types of antimalarial drugs used in the Netherlands to
prevent malaria if you are travelling to an area with a high risk of malaria:
atovaquone/proguanil, doxycycline, mefloquine and chloroquine. Below you can read how to take the
treatment used. In consultation with your traveller's advisor, we will coordinate which remedy is appropriate
is for you. For example, some drugs should not be used during
pregnancy, breastfeeding or if you have a chronic illness.
Also, always read the package insert of the antimalarial drugs listed below. If within an hour
vomits after taking the tablets, you should take a new dose.
When and how do I take antimalarial drugs (chemoprophylaxis)?
➤ Atovaquon/proguanil 250/100mg, tablet (as unbranded tablets and as Malarone®
available).
Adults:
● Start on the day before arrival and continue until seven days after leaving the
malaria area;
● Take one tablet every day with a fatty meal or dairy drink;
● Side effects are generally mild
● Possible side effects: abdominal pain, nausea, diarrhoea, headache, aphthous ulcers (small sores in
the mouth) and temporary hair loss.
Children:
Atovaquon/proguanil 62.5/25mg, tablet (as unbranded tablets and as Malarone junior®
available). Note: Dosage for children depends on weight.
< 5kg: do not give
● 5 to 8kg: ½ children's tablet per day
● 9 to 10kg: ¾ child tablet per day
● 11 to 20kg: 1 child tablet per day
● 21 to 30kg: 2 children's tablets per day
● 31 to 40kg: 3 children's tablets per day
● 40 kg: 1 adult tablet per day
➤ Doxycycline 100mg, tablet (different manufacturers).
Adults:
● Starting on the day before arrival and continuing until four weeks after leaving the
malaria area;
● Take one tablet every day;
● Take well before bedtime in a sitting or standing position with a generous
amount of water;
● Possible side effects: gastrointestinal symptoms, allergic reactions, vaginal
fungal infections or skin rashes from long stays in bright sunshine.
Children: Note: Dosage for children depends on weight and age.
● < 8 years: do not give
● ≥ 8 years and ≤ 45kg: 2mg/kg
● ≥ 8 years and > 45kg: 1 adult tablet per day
➤ Mefloquine 250mg, tablet (Lariam)c
Adults:
- Starting three weeks before arrival and continuing until four weeks after leaving the
malaria area; - In case of insufficient time until departure, a modified schedule can also be started.
- Take one tablet every week;
- Take with at least one glass of liquid and not on an empty stomach;
- Possible side effects: nausea, abdominal pain and dizziness. Sometimes complaints of restlessness,
poor sleep and vivid dreams. Serious psychiatric side effects are very
rare.
Children: Note: Dosage for children depends on weight.
< 5kg: do not give
● 5 to 20kg: ¼ tablet per week
● 21 to 30kg: ½ tablet per week
● 31 to 45kg: ¾ tablet per week
● 45kg: 1 tablet per week
➤ Chloroquine 100mg, tablet (Artecef®).
Adults:
- Starting on the day of arrival and continuing up to four weeks after leaving the
malaria area; - On arrival: take one tablet for the first two days, then one tablet every week thereafter
on the same day; - Take during or after meals;
- Possible side effects: gastrointestinal symptoms. Sometimes complaints of anxiety and insomnia
Children: Note: Dosage for children depends on weight.
● < 5kg: ¼ tablet per week
● 5 to 10kg: ½ tablet per week
● 11 to 20kg: 1 tablet per week
● 21 to 30kg: 1½ tablet per week
● 31 to 45kg: 2½ tablets per week
● 45kg: 3 tablets per week
What if I think I have malaria after returning to the Netherlands?
Even after returning to the Netherlands, you may experience 'flu-like' symptoms during the first few months
get, with or without fever. These symptoms may be the first signs of a
incipient (severe) malaria infection. If so, consult your (family) doctor and mention that you have recently
have been in a malaria area.
See also www.lcr.nl > advice by country.
See also www.lcr.nl > disease information.
Download the leaflet below!
