Useful tips for you on avoiding malaria

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