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Articles » Preventing Malaria in Infants and Children: DPD
 

Preventing Malaria in Infants and Children: DPD

Article title: Preventing Malaria in Infants and Children: DPD

Conditions: Malaria

Source: DPD


 


Information for the Public:
Preventing Malaria in Infants and Children

 

See Your Health Care Provider

  • 4–6 weeks before travelif your trip is outside the United States or Canada.
  • Find out what shots and prescriptions your child needs.

Know Your Risk

  • Malaria is a serious but preventable disease spread by the bite of an infected mosquito.
  • Anyone, any age, can contract malaria.
  • Enjoy your trip; follow the few simple precautions listed below to keep you and your family from getting malaria.

CDC has three sources of information about malaria risk and prevention:

  • Toll-free Voice Information Service. Call 1-877-FYI-TRIP.
  • Toll-free Fax Information Service. Call 1-888-232-3299 and listen to the instructions. Request document number 000005 for a directory of all available travel faxes.
  • The CDC Travelers' Health website.

    Identical malaria prevention information is provided at the CDC website and through CDC's toll-free Fax Information Service.

Give Your Child Antimalarials as Directed

Drugs to prevent malaria, called antimalarials, are available only by prescription through a health care provider. Your health care provider will prescribe your child's antimalarial based on the travel itinerary and medical history. Some antimalarial drugs are more effective in some parts of the world than others. In addition, a medical condition may prevent your child from taking certain drugs. Alternative drugs are available and are discussed below.

Antimalarial Warnings and Instructions

  • Overdosage of antimalarials can be fatal. Keep drugs in childproof containers out of the reach of children.
  • Give antimalarials to children exactly on schedule without missing doses.
  • For young children who cannot swallow tablets, have their prescription filled at a full-service pharmacy. Your pharmacist will need to make a special drug preparation for your child to take. The pharmacist should grind the tablet, weigh each dose, and store the powder in a gelatin capsule. Plan ahead; it will likely take 3–4 days for the prescription to be filled.
  • Mefloquine, chloroquine, and Malarone™ taste very bitter. To give your child the medicine, break open the gelatin capsule and mix the drug with something sweet, such as applesauce, chocolate syrup, or jelly.
  • Buy antimalarials in the United States before travel overseas. The quality of antimalarials sold outside of the United States may not be reliable.

Find Out Which Drug Is Recommended for Your Child

Your child will be prescribed one of the following antimalarials. Find the drug below; read the directions for use and side effects. If you have questions about the drug recommended for your child, call your child's health care provider or pharmacist.

  • Children traveling to malaria-risk areas in South America, Africa, the Indian subcontinent, Asia, and the South Pacific should take one of the following drugs: mefloquine, doxycycline, or Malarone.™
Mefloquine/ brand name Lariam®*

Directions for use

  • Your child's health care provider will prescribe mefloquine based on your child's weight.
  • Give the first dose of mefloquine 1 week before arrival in the malaria-risk area.
  • Give mefloquine once a week, on the same day of the week, while in the malaria-risk area.
  • Give mefloquine once a week for 4 weeks after leaving the malaria-risk area.
  • Mefloquine should be taken on a full stomach, for example, after dinner.

Mefloquine side effects
Most children who take mefloquine have few, if any, side effects. The most common side effects in children are nausea and vomiting. These usually do not require stopping the drug. If your child vomits the drug within 30 minutes, give the child another dose of the drug (mix with something sweet, like pudding or applesauce). If he or she vomits after 30 minutes, enough of the drug has been absorbed and you do not have to give a second dose. Mefloquine very rarely causes serious side effects such as seizures. Children who have serious side effects should be taken to a health care provider.

Children should NOT take mefloquine if they have

  • Ever had an allergic reaction to mefloquine;
  • Epilepsy or other seizure disorders;
  • A severe psychiatric disorder;
  • Been diagnosed or treated for an irregular heartbeat.
  • Alternative drugs for children who cannot take mefloquine include doxycycline or Malarone.™

Doxycycline

Directions for use

  • Your child's health care provider will prescribe doxycycline based on your child's weight.
  • Give the first dose of doxycycline 1 or 2 days before arrival in the malaria-risk area.
  • Give doxycycline once a day, at the same time each day, while in the malaria-risk area.
  • Give doxycycline once a day for 4 weeks after leaving the malaria-risk area.

Doxycycline side effects and warnings

  • Do not give to children under the age of 8; teeth may become permanently stained.
  • Taking doxycycline may cause children to sunburn faster than normal. To prevent sunburn, have your children avoid midday sun, wear a high-SPF sunblock, wear long-sleeved shirts, long pants, and a hat.
  • Give children doxycycline on a full stomach to lessen nausea; children should not lie down for 1 hour to prevent reflux (burping up stomach acid).
  • Alternative drugs for children who cannot take doxycycline include mefloquine or Malarone.™

Malarone™

Directions for use

  • Your child's health care provider will prescribe Malarone based on your child's weight.
  • Give the first dose of Malarone 1 or 2 days before travel to the malaria-risk area.
  • Give Malarone once a day in the malaria-risk area.
  • Give Malarone once a day for 7 days after leaving the malaria-risk area.
  • Give the dose at the same time each day with food or milk.

Malarone Side Effects and Warnings
Although side effects are rare, abdominal pain, nausea, vomiting, and headache can occur. Malarone should not be taken by infants weighing less than 11 kg (24 lbs). Malarone should not be taken by patients with severe renal impairment.

  • Children traveling to malaria-risk areas in Mexico, Haiti, the Dominican Republic and certain countries in Central America, the Middle East, and Eastern Europe should take either chloroquine or hydroxychloroquine sulfate as their antimalarial drug.

Chloroquine/ brand name Aralen®*

Directions for use

  • Your child's health care provider will prescribe chloroquine based on your child's weight.
  • Give the first dose of chloroquine 1 week before arrival in the malaria-risk area.
  • Give chloroquine once a week, on the same day each week, while in the malaria-risk area.
  • Give chloroquine once a week for 4 weeks after leaving the malaria-risk area.
  • Chloroquine should be taken on a full stomach, for example, after dinner, to lessen nausea.

Chloroquine side effects
Although side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching have been reported. Chloroquine may worsen the symptoms of psoriasis.

  • Chloroquine is sold in the United States in tablet form only.
  • In foreign countries, drug companies sell chloroquine as a syrup. Parents should consult the local pharmacist for the correct dosage of chloroquine.

Hydroxychloroquine sulfate/ brand name Plaquenil®*

Directions for use

  • Your child's health care provider will prescribe hydroxychloroquine sulfate based on your child's weight.
  • Give the first dose of hydroxychloroquine sulfate 1 week before arrival in the malaria-risk area.
  • Give hydroxychloroquine sulfate once a week, on the same day each week, while in the malaria-risk area.
  • Give hydroxychloroquine sulfate once a week for 4 weeks after leaving the malaria-risk area.
  • Take hydroxychloroquine sulfate on a full stomach, for example, after dinner, to minimize nausea.
  • Hydroxychloroquine sulfate may be better tolerated than chloroquine.

Hydroxychloroquine sulfate side effects
Although side effects are rare, nausea and vomiting, headache, dizziness, blurred vision, and itching have been reported. Hydroxychloroquine sulfate may worsen the symptoms of psoriasis.

Prevent Insect Bites

Protect your child from mosquito bites. Have him or her wear long-sleeved shirts and long pants; apply insect repellent to exposed skin. Mosquitoes that transmit malaria bite between dusk and dawn. Use insect repellents that contain DEET.

When using repellent with DEET, follow these precautions

  • Always use according to label directions.
  • Use only when outdoors and wash skin after coming indoors.
  • Do not breathe in, swallow, or get into the eyes.
  • Do not put on wounds or broken skin.
  • The concentration of DEET varies among repellents. Repellents with DEET concentrations of 30% to 35% are quite effective, and the effect should last about 4 hours.

Travelers who will not be staying in well-screened or air-conditioned rooms should use a pyrethroid-containing flying-insect spray in living and sleeping areas during evening and nighttime hours. In addition, travelers should take additional precautions, including sleeping under mosquito netting (bed nets). Bed nets sprayed with the insecticide permethrin are more effective. In the United States, permethrin is available as a spray or liquid to treat clothes and bed nets. Bed nets may be purchased that have already been treated with permethrin. Permethrin or another insecticide, deltamethrin, may be purchased overseas to treat nets and clothes.

Know the Signs and Symptoms of Malaria

Malaria can occur despite taking antimalarials. Malaria causes a flu-like illness; symptoms include fever, shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria symptoms will occur at least seven to nine days after being bitten by an infected mosquito. Fever in the first week of travel in a malaria-risk area is unlikely to be malaria; however, ill travelers should still seek immediate medical care. Although malaria is unlikely to be the cause, any fever should be promptly evaluated. If you or your child becomes ill with a fever or flu-like illness while traveling in a malaria-risk area and up to 1 year after returning home, seek immediate medical care. Tell your health care provider where you have been traveling.

For additional information on malaria risk and prevention, please see the following:

  • Malaria: General Information
  • Prescription Drugs for Preventing Malaria (Information for the Public)
  • Preventing Malaria in the Pregnant Woman (Information for the Public)

 

*Use of trade names is for identification purposes only and does not imply endorsement by the Public Health Service or by the U.S. Department of Health and Human Services.

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the disease described above or think that you may have a parasitic infection, consult a health care provider.

 

 

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