Malaria

Question 1

Maloff Protect 250/100

P

Answer 1

• Atovaquone with proguanil
• in adults over 18 years for up to 12 weeks
• T OD to be commenced 1-2 days prior to entering a malaria-endemic area, continued during period of stay and for seven days after leaving the area

Question 2

Maloff indication

Answer 2

• Prevention of malaria
• Adults aged 18 years and over
• Weigh more than 40kg
• For people who are travelling to areas where malaria is widespread
• Especially recommended for prevention where the pathogen may be resistant to other anti-malarials

Question 3

What are the 4 antimalarial medications available as P meds?

Answer 3

• Maloff protect 250/100
• Avloclor (chloroquine 250mg)
• Paludrine (proguanil 100mg)
• Paludrine/Avlocor (Proguanik 100mg/chloroquine 250mg)

Question 4

Protection against bites (Malaria)

Answer 4

• Use mosquito nets impregnated with a pyrethroid insecticide (e.g. permethrin)
• Wear long sleeves and trousers after dusk
• Use DEET (safe in adults and children over 2 months and can be used in pregnancy and BF)

Question 5

DEET application

Answer 5

• Duration varies according to the [] of DEET and is longest for 50%
• If sunscreen is worn then DEET should be applied after as it reduces the SPF of sunscreen, therefore a SPF of 30-50 should be worn

Question 6

Epilepsy

Answer 6

• Chloroquine and mefloquine are NOT suitable for malaria prophylaxis if there is a history of epilepsy
• Doxy or atovaquone with proguanil may be used but NB doxy can interact with some epilpetic medicines and therefore its dose may need to be adjusted

Question 7

Length of prophlyaxis

Answer 7

Proguanil and chloroquine=1 week before travel
Mefloquine= 2-3 weeks before travel
Doxycycline or atovaquone with proguanil= 1-2 days before travel

SHOULD BE CONTINUED FOR 4 WEEKS AFTER LEAVING AREA apart from atovaquone with proguanil hydrochloride which is to be stopped for 1 week after leaving

Question 8

Maloff Protect 250/100 Contra-indications

Answer 8

• Previous hypersensitivity to the active substances or any of the excipients
• Diagnosed renal impairment of any severity
• Diagnosed hepatic impairment of any severity
• Children and adolescents

Question 9

Maloff protect referral criteria

Answer 9

• Pregnant
• BF
• Patients with a history of depression, seizures
• Patients with TB
• If needing quantities longer than 12 weeks travel
• Patients under 18 years
• Patients who weigh less than 40kg

Question 10

Maloff Side Effects

Answer 10

Headache
Nausea + Vomiting 
Abdominal pain 
Diarrhoea 
Severe allergic or skin reactions