Malaria during pregnancy is a serious illness for both the mother and the foetus. Pregnant women should be advised against travel to an area with malaria, particularly it there is chloroquine resistant Plasmodium falciparum. Results of animal studies indicate that tetracyclines cross the placenta, are found in foetal tissues and can have toxic effects on the developing foetus (often related to retardation of skeletal development).

Breastfeeding women should not take doxycycline or atovaquone/proguanil (Malarone®). Chloroquine plus proguanil can be used during breastfeeding although this combination provides suboptimal protection for the mother in areas of chloroquine resistant Plasmodium falciparum malaria. There is little data on the use of mefloquine during breastfeeding (see Use of Mefloquine during Breastfeeding).

Proguanil, atovaquone/proguanil and mefloquine do not cause problems in those with psoriasis. Chloroquine and chloroquine-related drugs can exacerbate psoriasis and should be avoided in those with generalised psoriasis or a history of such. Travellers with mild psoriasis can consider chloroquine if they are aware of the possible risks. The benefit of chemoprophylaxis with chloroquine may outweigh the risk of exacerbation of psoriasis, but each case should be considered on an individual basis.

Travellers on anticoagulants should ensure their clotting time is stable prior to departure. It should be noted that patients on warfarin may have underlying cardiac disease and may be on cardiac medication. Interactions with other medication together with the individual’s medical history should be taken into account when deciding on appropriate malaria prevention tablets.

Both chloroquine and mefloquine are unsuitable for those with epilepsy. For areas with a high risk of chloroquine resistant Plasmodium falciparum, doxycycline or atovaquone/proguanil can be used. However for children under the age of 12 the only suitable malaria prevention tablet under these circumstances will be atovaquone / proguanil (Malarone®) (bearing in mind the length of travel). Proguanil alone can be given for malarious areas without chloroquine resistance.

Guidelines for the long term use of malaria tablets are summarised in Chapter 7 of the malaria guidelines, and were originally published in 2003 by the ACMP: Malaria prophylaxis for long-term travellers. Comm Dis Public Health 2003; 6: 200-8. The main issues influencing the choice of malaria prevention tablets on a long-term basis are the same as for short-term, i.e. adverse event profile, ease of compliance and efficacy.

Both chloroquine and proguanil can be given from birth. Chloroquine is available as syrup but proguanil will need to be crushed and given with jam or food. Mefloquine can be given to infants weighing 5 kg or more (see SPC). Atovaquone/proguanil (Malarone®) can be given to infants weighing 11 kg or more; paediatric tablets are available. One of the main challenges in giving malaria prevention tablets to babies and young children will be the practical aspects of administration.

Northern parts of South Africa and most countries in Africa are Malaria areas. Malaria is a potentially fatal disease. Please ensure that you have consulted your doctor as to what prophylactics you should take for that particular country being that there are many different strains of Malaria. Further information is available on this site. Read More about Malaria Prevention.

The money raised by the volunteers contributes to the necessary and recommended vaccinations for the placement cities. Malaria tablets are recommended for both countries. You are required to take any medication that is advised by your GP and/ or the Tropical Medical Bureau (or equivalent) before going overseas.

Cruises are a growing part of the holiday market. Most travellers on cruises are only ashore during daylight hours when the Anopheles mosquito vector of malaria is not feeding, and therefore do not require malaria chemoprophylaxis. Occasionally this is not the case and therefore the cruise itinerary must be reviewed to determine if there will be exposure to malaria.

Although electrology has never been proven harmful to pregnant women, it is suggested the advice of your physician be sought before treatment.

Although Electrolysis has never been proven harmful to pregnant women, it is suggested that you seek the advice of your physician before you continue or begin treatment.

Generally, they should not be taken. If a diabetic has already been on tablets before pregnancy, she should change to insulin therapy until after delivery.

The doctor wanted your money. You and your doctor are probably in a country which does not operate free health systems like those of the countries of the European Union, Australia and New Zealand. Except for crossing the road, there are no frequent or serious health hazards in Thailand. Vaccinations are not required for any tropical diseases, and there is absolutely no need whatsoever to take malaria prophylactics, and snake bites are as rare as they are in England.