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Guidelines for malaria prevention in Oceania

Written by Helen Marshall, pharmacist

In Papua New Guinea, the Solomon Islands, and Vanuatu there is a high risk of contracting relatively chloroquine-resistant falciparum malaria. There are some reports of chloroquine-resistant vivax malaria. Doxycycline or mefloquine or Malarone are the recommended preventive medicines for these areas. As is usual with vivax malaria, there is a risk of later attacks for a year or more after visiting these areas, even if preventive medicines have been taken, and any fevers and flu-like illnesses should be reported to your doctor for urgent investigation.

Risk	Country	Preferable regimen
Risk high, chloroquine resistance high	Papua New Guinea (below 1800m) Solomon Islands Vanuatu	Doxycycline OR mefloquine OR Malarone

Always see your pharmacist for more detailed information about the risks of malaria in each country you are visiting. Your pharmacist will be able to tell you which medicines are recommended.

Remember to tell your pharmacist:

if you are pregnant, planning a pregnancy or breastfeeding
if you suffer from any diseases or conditions
if you are taking any regular medications
if a child is travelling with you.

This information will help the pharmacist recommend the most appropriate regimen for you.

Remember to leave yourself enough time before you leave to obtain your medicines. All the malaria prevention medicines must be started before you travel. Mefloquine needs to be started two-and-a-half weeks before travel , chloroquine and proguanil should be started a week before, and Malarone and doxycycline one to two days before travelling.

Chloroquine (Avloclor or Nivaquine) and proguanil (Paludrine) can be bought from pharmacies, but may have to be ordered in if you are going for a long trip. Mefloquine (Lariam), doxycycline (eg Vibramycin) and Malarone all require a prescription from your doctor.

For these reasons always see your pharmacist at least three weeks before you plan to travel, to find out which (if any) medicines are recommended, when you need to start taking them, and whether you need a prescription to obtain them.

Remember to take your medicines regularly while you are away, and continue taking them for four further weeks after leaving the malarious area, with the exception of Malarone, which only needs to be continued for one week after leaving.

Always suspect malaria and seek urgent medical advice if you develop a fever or flu-like illness whilst you are away (even if you are taking preventive medicines) or up to a year after you return, in particular in the first three months.

Last updated 16.03.2007

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