Malaria occurs throughout Mozambique, right through the
Malaria is spread by the Anopheles mosquito, so
preventing yourself being bitten is of paramount
Mosquito nets and repellents are strongly
recommended after sundown.
Try to avoid being bitten by
wearing clothing that covers the arms,legs and ankles and use
repellant' - (See DEET below) - on the exposed parts of your
body as well as sleeping under treated mosquito nets.
in malaria areas use effective DEET insect repellents
Try and ensure that the
doors and windows of your accommodation are screened against
mosquitoes and try and keep them closed, especially before
dusk. Having a fan or air-conditioner on at night will keep
mosquito activity down to a minimum.
Malaria prophylaxis is recommended for all travelers to
The three most commonly used ones are;
taken once weekly in a dosage of 250 mg, starting one-to-two
weeks before arrival and continuing through the trip and for
four weeks after departure.
Mefloquine may cause mild
neuropsychiatric symptoms, including nausea, vomiting,
dizziness, insomnia, and nightmares.
Other reactions can
occur, including depression,anxiety, psychosis,
hallucinations, and seizures.
Mefloquine should not be
given to anyone with a history of seizures, psychiatric
illness, cardiac conduction disorders, or allergy to quinine
Those taking mefloquine (Lariam) should read
the Lariam Medication Guide and possibly conduct tests before
2.) (PDF). Atovaquone/proguanil (Malarone)
is a recently approved combination pill taken once daily with
food starting two days before arrival and continuing through
the trip and for seven days after departure.
which are typically mild, may include abdominal pain, nausea,
vomiting, headache, diarrhea, or dizziness. Serious adverse
reactions are rare.
3.)Doxycycline is effective, but
may cause an exaggerated sunburn reaction,
its usefulness in the tropics
Travelers who will be visiting remote areas in Mozambique
for an extended time and as a result may not have easy access
to medical care, should bring along medications for emergency
self-treatment should they develop symptoms of
Symptoms such as fever, chills, headaches, and
muscle aches, should be considered as an indication of
Malaria symptoms can sometimes not occur for
months or even years after exposure.
Coartem malaria drug works best, study finds, May 23 2007 at 01:37AM
By Julie Steenhuysen
Chicago - In the fight against drug-resistant malaria, a combination drug made by Novartis AG appears to work better than other recommended treatments, US researchers said on Tuesday, in a finding that might help guide treatment for
the deadliest form of the disease
Ugandan children who received the combination of artemethere-lumefantrine, also known as Coartem, had the lowest rate
of treatment failure of three leading combination therapies studied, researchers reported in the Journal of the
American Medical Association
Coartem is an artemisinin-based therapy or ACT, which have been shown to be more effective and to delay development of
the disease. Researchers compared it to two other treatments recommended by the World Health Organisation for
drug resistant malaria - another ACT therapy made by Sanofi-Aventis and a lower-cost combination drug.
'All ACTs should not be considered equivalent regimens'
Coartem fared much better than a competing ACT drug.
"All ACTs should not be considered equivalent regimens," Dr Grant Dorsey of the University of California, San Francisco,
and colleagues wrote.
But the study also showed the benefit of consistent, high quality care.
"Prompt delivery of treatment provided through health facilities involved in the study improved clinical outcomes,
even if less efficacious therapy was delivered," Drs Gianna Zuccotti and Catherine DeAngelis wrote in an editorial.
Malaria kills a million people a year, mostly children under age five in Africa south of the Sahara.
The mosquito-borne disease has grown resistant to older drugs that have been replaced by combination treatments,
especially to fight Plasmodium falciparum, the deadliest strain of the disease.
The researchers studied the three leading available combination therapies for treating uncomplicated falciparum malaria
for safety, effectiveness and tolerability between November 2004 and June 2006.
The trial included 601 children from an urban community in Kampala, Uganda, who were treated with one of three combination
drugs - amodiaquine plus sulfadoxine-pyrimethamine, amodiaquine plus artesunate, or artemether-lumefantrine.
Of the three combinations, artemether-lumefantrine fared best, with a risk for treatment failure of 6,7 percent.
Amodiaquine plus artesunate - a cheap therapy combining the artemisinin derivative artesunate with the older
antimalarial amodiaquine - had risk for failure rate of 17,4 percent.
Amodiaquine plus sulfadoxine-pyrimethamine, a low-cost combination of two older drugs, fared worst, with a risk for
failure rate of 26,1 percent.
"Our study suggests that the efficacy of amodiaquine plus sulfadoxine-pyrimethamine is decreasing in Kampala, " the researchers wrote.
The research was part of a JAMA special section on malaria.
Diarrhoea is a very common ailment when traveling.
Most cases of diarrhoea when traveling are mild and do not
require either antibiotics or anti-diarrhoea
Adequate fluid intake is essential for any
traveler suffering from diarrhoea, to prevent dehydration.
The most important aspect of preventing diarrhoea is
treatment and care, as far as food and water intake is
Travelers are advised to carry with them an
antibiotic as well as an anti-diarrhoea drug, to be taken as
soon as significant diarrhoea starts.(Three or more loose
stools in an 8-hour period or five or more loose stools in a
If diarrhoea is combined with nausea,
vomiting, cramps, fever or blood in the stool, an antibiotic
should be administered.
Ciprofloxacin (Cipro)(PDF) 500 mg
twice daily or
Levofloxacin (Levaquin) (PDF) 500 mg once
daily for a total of three days.
Quinolones are generally
well-tolerated, but occasionally cause sun sensitivity and
should not be given to children, pregnant women, or anyone
with a history of quinolone allergy.
treatment could be a three day course of rifaximin (Xifaxan)
200 mg three times daily or azithromycin (Zithromax) 500 mg
Rifaximin should not be used by those with
fever or bloody stools and is not recommended for pregnant
women or children under the age of 12.
be avoided in those allergic to erythromycin or related
An antidiarrhoea medicine such as loperamide
(Imodium) or diphenoxylate (Lomotil) should be taken as needed
to slow the frequency of stools, but not enough to stop the
bowel movements completely.
Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under the
age of 2.
If diarrhoea is, severe, bloody, or if fever
occurs accompanied by shivering and chills, or if abdominal
pain becomes severe, or if diarrhoea lasts for more than 72
hours, medical attention should be sought.
antibiotics are effective, they should not be taken as a
Food and water precautions;
Don't drink tap water unless
it has been boiled, filtered, or chemically disinfected.
Don't drink un bottled beverages or put ice in your drinks
unless you know that the ice is safe to drink.
fruit or vegetables unless they have been washed very
thoroughly peeled or cooked.
Avoid cooked foods that are no longer hot. because cooked food that has been left at room
temperature can be very dangerous.
Avoid un pasteurized milk and any products that might have been made from un pasteurized
milk.When using powdered milk make sure the water you mix it with is safe.
Avoid food and beverages obtained from street
Do not eat raw or undercooked meat or fish.