Useful tips for you on avoiding malaria
This interactive health column appears in cooperation with the Singapore-based Parkway Group Healthcare. Readers are encouraged to ask questions through features@thejakartapost.com.
Question:
Dear Dr. Oon Chong Teik,
It was with great interest that we read an article about the treatment of malaria using Artesunate in The Jakarta Post on Sept. 13. As the paper encouraged readers to ask questions on the subject, we would like to present our case with the kind request to have your comments.
We are a married couple, both 51 years old, from the Netherlands and we are preparing, by taking language training in Bandung, to go to Irian Jaya to help with community development. In the area where we will live, the anophline mosquito is quite active. In June/July of this year, we went there for orientation and used Lariam Mefloquine (1 tablet of Lariam per week, containing 250 milligrams of mefloquine) to prevent malaria or to reduce the chances of getting it. Lariam is known to have nasty side effects and my wife apparently was badly affected.
Next month, we plan to return to Irian Jaya for a period of four years. We will not use Lariam anymore because of the toxic side effects and neither would we like to use quinine for prevention purposes.
Although your paper seemed to refer to the treatment of malaria using Artesunate rather than for prevention purposes, we would be interested to hear from you whether Arteunate could also be used for prevention? Would that be the case, or should it still be used in combination with mefloquine, albeit at a lower dosage.
We have just heard that the leaf of the papaya tree can also be used in combination with the leaf of the cassava. Do you know anything about this?
Anyway, would you be able to recommend what to use to prevent malaria? It is not for the purpose of treatment of the illness but for prevention only. I would be much obliged to hear your comments.
Yours sincerely,
-- Martin Horstman
Bandung, West Java
Answer:
Dear Mr. Horstman,
Artesunate should not be used as a prophylaxis, as such use will encourage the development of drug resistance. It is mainly used for treatment in combination with Lariam at the appropriate dosage. Since you will be back in Irian Jaya for four years, you could use insect repellents on your skin, permethrin repellent on clothing, etc. Should you have a fever when you are in Irian Jaya and malaria is suspected, blood screening should be done or see if there is an appropriate standby drug for treatment. Papaya and cassava leaves are known in folk medicine and used to treat malaria, but not all fevers are due to malaria. I am not aware of the use of papaya and cassava leaves as a malaria prophylaxis, but I do know that there are many species of cassava and some are poisonous. I would advise you to keep to proven antimalarials.
-- Dr. Oon Chong Teik
Question:
Dear Dr. Chong Teik,
My 14-year-old son is going camping at Ujung Kulon park. Can I get some good advice? I found your Sept. 13 article on malaria useful.
Thank you,
-- Evans
Answer:
Dear Evans,
Your son is going to Ujung Kulon park for camping in an area with possible malaria. He is advised to use an insect repellent containing DEET on his skin, wear long-sleeved shirts, long pants and don't forget a cap to cover the head. Spray Permethrin on clothes, the mosquito net, sheets, etc. No malaria prophylaxis is foolproof, but should you decide to take one, start it before setting off on the trip, so you can change drugs should side effects occur. The common drugs are Lariam, Doxycycline and Chloroquine. Should fever occur on the trip or on return home, a screen for malaria should be done.
-- Dr. Oon Chong Teik