You are travelling to an area with a moderate risk of malaria, therefore anti-mosquito measures are advised.
The aim of anti-mosquito measures is to prevent severe malaria.
In some cases, you will also be given emergency malaria treatment.
You can use this emergency treatment if you do contract malaria.
Find out more about malaria, how to prevent it and emergency treatment here.
What is malaria?
Malaria is an infectious disease caused by malaria parasites. These parasites
enter 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 (am
you short of breath). The fever is not always high and it does not always make you shiver. Certain groups
travellers such as young children (<5 years old) 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 it from the Plasmodium falciparum parasite.
You can die from that in a matter of days. In general, malaria tropica is good
treatable if treatment is started in time. In that case, the disease must be timely
recognised. - 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 certain areas in Asia and South America, you 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 by
person differ. This may, for example, be due to medication use, pregnancy or
your state of health.
PROTECTION AGAINST MOSQUITO BITES
The following anti-mosquito measures of
dusk to dawn. During the day it is also important to protect yourself from mosquitoes
which can transmit other diseases:
- Wear well-covering clothes: long sleeves, long trousers, closed shoes with socks;
- On uncovered body parts, use insect repellent containing DEET, see for
more information on dosages 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.
EMERGENCY TREATMENT
It is generally advised to take an emergency treatment with you when travelling if you don't
can be at a hospital or doctor's office within 48 hours for malaria diagnosis and treatment. Your
can then treat yourself in case of (suspected) malaria.
- In case of characteristics of malaria visit a hospital or doctor as soon as possible to get
Examine whether you have malaria. - If you are unable to reach a hospital or doctor within 48 hours of the onset of symptoms,
then if symptoms with fever persist or recur for more than 24 hours, take the
emergency treatment as prescribed (see below). The emergency treatment is to
prevent getting seriously ill from malaria.
After starting emergency treatment, it is still necessary to see a doctor as soon as possible
consult. This is to make sure the symptoms do not have another cause. If
the symptoms are indeed caused by malaria, it is important to have treatment
monitored by a doctor. Additional treatment may be required.
How do I take emergency treatment?
There are two different types of emergency treatment: atovaquone/proguanil and
artemether/lumefantrine. Below is how to use the treatment. In consultation with the
traveller's advisor will coordinate which drug is suitable for you. Some remedies may
for example, should not be used during pregnancy, breastfeeding or if you are
have a chronic illness.
Also, always read the package insert of the antimalarial drugs listed below. If you are within an hour of
taking the tablets vomits, you should take a new dose.
- Atovaquon/proguanil 250/100mg, tablet (as unbranded tablets and as Malarone®
available):
a. Adults:
- 4 tablets daily for 3 days;
- Take the 4 tablets at once;
- Take the tablets with food and at the same time;
- Dosage for children depends on weight, see below;
- Possible side effects include abdominal pain, nausea, diarrhoea, headache and sometimes vomiting.
b. Children
Atovaquon/proguanil 250/100mg, tablet (available as unbranded tablets and as Malarone®)
- 11 to 20 kg: 1 tablet daily for 3 days
- 21 to 30 kg: 2 tablets daily for 3 days
- 31 to 40 kg: 3 tablets daily for 3 days
- ≥ 41kg: 4 tablets daily for 3 days - Artemether/lumefantrine 20/120mg, tablet (available as Riamet® or Coartem®):
a. Adults
- 6 doses of 4 tablets;
- Take at time 0, 8, 24, 36, 48 and 60 hours;
- Dosage for children depends on weight, see below;
- Possible side effects include: decreased appetite, sleep disturbance, headache,
dizziness, nausea, vomiting, abdominal pain, muscle pain, joint pain and fatigue.
b. Children
Artemether/lumefantrine 20/120mg tablet (available as Riamet® or Coartem®):
- 15 to 24 kg: 6 doses of 2 tablets, according to schedule
- 25 to 34 kg: 6 doses of 3 tablets, according to schedule
- ≥ 35 kg: 6 doses of 4 tablets, according to schedule
dosage schedule: 0, 8, 24, 36, 48 and 60 hours
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 incipient
(severe) malaria infection. If so, consult your (family) doctor and mention that you have recently been in a
been to a malaria area.
See also www.lcr.nl > advice by country.
See also www.lcr.nl > disease information.
Download the leaflet below!
