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MALARIA CHEMOPROFILAXIS, TROPICAL MEDICINE NICOLAS OCAÑA - Coggle Diagram

- - - - Travelers born in regions with endemic malaria who relocate outside the endemic area but subsequently return to visit friends and relatives:
        
        Pose unique challenges for malaria prevention since those with acquired immunity afforded some degree of protection
      - Pregnant travelers should be advised to defer travel until after delivery whenever feasible.
      - Military personnel represent another important risk group; these individuals may have inadequate protection from mosquito bites given prolonged periods of night-time exposure to biting Anopheles mosquitoes with accommodations that have inadequate screens or bednets.
      - HIV-infected travelers warrant the same approach to prevention of malaria as HIV-uninfected travelers.
- - - - Options for chemoprophylaxis include atovaquone-proguanil, mefloquine, doxycycline, and tafenoquine; all four agents are highly efficacious for prevention of malaria.
      - Short-term travelers may prefer the shorter course of atovaquone-proguanil, whereas long-term travelers may prefer the convenience of weekly mefloquine.
        Doxycycline must be taken daily and may cause sun sensitization.
      - Travelers must be tested for G6PD deficiency before using tafenoquine.
    - - For travelers at risk of malaria infection in destinations where P. falciparum strains resistant to chloroquine and mefloquine are present (such as in the malaria-endemic regions of Thailand bordering Myanmar [Burma] and Cambodia [eg, eastern provinces of Myanmar (Burma) and western provinces of Cambodia], China, Laos, and Vietnam), mosquito avoidance measures should be used in conjunction with chemoprophylaxis. Options include atovaquone-proguanil, doxycycline, or tafenoquine.