Malaria Prophylaxis: How to Prevent Malaria When Travelling
Key Takeaways
- Malaria prophylaxis is prescription medication that helps protect against malaria when travelling to places where the disease is common.
- Anti-malarial medicines work by interrupting the parasite's life cycle, at the liver stage or in the blood.
- It is typically started before the trip and continued during it and for a period after returning, with timing that depends on the medicine.
- Side effects such as dizziness, headache or nausea are usually mild and short-lived.
Medically Reviewed By: Dr Jana Lim, Board-Accredited Family Physician
Board-Accredited Family Physician | MBChB, MMed (FM)
MBChB, MMed (FM) | Last updated:
What Is Malaria Prophylaxis?
Malaria prophylaxis refers to prescribed medication to protect against malaria infection when travelling to countries where the disease is common. Taken as a preventive measure, the medicine helps stop malaria parasites from multiplying in the body if an infected mosquito bites you.
The main species of Plasmodium parasites that cause malaria in people are P. falciparum, P. vivax, P. malariae, P. ovale and P. knowlesi. Infected female Anopheles mosquitoes carry these parasites, which attack red blood cells once they reach the bloodstream. Without prevention or early treatment, the infection can cause serious illness.
Prophylaxis protects more than the individual traveller, since it also helps stop malaria from being carried back into malaria-free countries. Imported malaria cases reported in Singapore have stayed under 40 each year since 2018, with surveillance and mosquito control keeping local transmission low.
What Are Symptoms and Complications of Malaria?
Malaria often begins with symptoms that resemble a viral infection, but it can rapidly progress to severe disease if untreated. The illness usually develops about one to several weeks after a bite from an infected mosquito.
Typical symptoms include:
- Fever that may fluctuate or return in cycles
- Chills or shivering episodes
- Headache and fatigue
- Muscle or joint pain
- Nausea, vomiting, or loss of appetite
If medical care is delayed, malaria can cause complications such as severe
anaemia, breathing difficulties, seizures, organ failure, or in extreme cases, death.
Pregnant
women, young children, and individuals with compromised immunity are particularly susceptible to
severe malaria.
How Does Malaria Prophylaxis Work?
Anti-malarial medicines work by interrupting the parasite’s life cycle before infection
takes hold. Some act on the liver stage and others on parasites in the blood, which helps stop the
disease progressing after a bite.
Commonly prescribed preventive medications include atovaquone-proguanil,
doxycycline, mefloquine, and chloroquine. As these are prescription-only
medicines, you will need to consult a doctor for a medical assessment before obtaining them.
The choice of prophylaxis depends on several factors such as travel destination, regional
resistance patterns, duration of stay, existing medical conditions, and possible drug
interactions.
Your doctor can advise on the most appropriate regimen, discuss possible
side effects, and recommend additional preventive steps such as using insect repellent and wearing
protective clothing.
When Should I Start Malaria Prophylaxis?
Malaria prophylaxis starts before you enter an area where malaria is prevalent and continues through the trip and for
a period afterwards, to clear any parasites picked up while travelling.
The timing for starting and stopping
medication varies by drug: mefloquine begins one to two weeks before
departure and continues for several weeks after returning, while atovaquone-proguanil begins one or
two days before travel and stops about a week after leaving the area.
It is essential to follow the recommended schedule precisely, as missing doses or stopping early may
leave you vulnerable to infection. Consult your doctor well in advance of your trip to ensure you
begin the medication at the appropriate time.
What Are Side Effects of Malaria Prophylaxis?
Most people tolerate malaria prophylaxis without problems, though some may experience mild, short-lived side effects. Common symptoms can include:
- Dizziness or a sense of light-headedness
- Headache
- Nausea, abdominal discomfort, or vomiting
These reactions usually ease as your body adjusts to the medicine. To reduce discomfort, take the medication
with food or at the same time each day as advised by your doctor.
If you experience severe or persistent symptoms such as intense stomach pain, mood changes, vision problems,
irregular heartbeat, or allergic reactions like rash and swelling, seek medical advice promptly. An alternative
anti-malarial that is better suited to your needs may be considered.
What Is the Cost of Malaria Prophylaxis in Singapore?
At Singapore Women's Clinic, we offer anti-malarial medications with the following prices:
| Medication | Price* |
|---|---|
| Consultation | From $49.05 |
|
Malarone (Atovaquone-Proguanil)
Typical Dosage: 2 days + duration of travel + 7 days after returning (1 tab per day)
Typical Dosage: 2 days + duration of travel + 7 days after returning (1 tab per day)
|
$14.17 per tab |
|
Doxycycline
Typical Dosage: 2 days + duration of travel + 28 days after returning (1 tab per day)
Typical Dosage: 2 days + duration of travel + 28 days after returning (1 tab per day)
|
$1.09 per tab |
| Period Delay Pill (Norethisterone 5 mg) | $0.76 per tab |
*All prices are NETT and inclusive of GST.
Payment Options We Accept
In addition to malaria prophylaxis, we provide a wide selection of travel-related vaccinations and a travel medical kit designed to keep you well protected and ready for any health needs during your journey.
