From Dr. Keystone’s talk at U of M, March 24, 2001, I recorded the following:

  1. What is the risk of malaria in persons who do not take chemoprophylaxis in visiting certain areas of the world for > 1 month — Mexico and Central America 1:10,000; S.E. Asia 1:1,000; Africa 1:50, and Oceania 1:5;
  2. 3% of persons taking mefloquine discontinue the drug; 1:200-500 have neuropsychiatric problems; seizures and psychosis occur in 1:10,000-13,000 persons on the medication.
  3. Mefloquine is the only drug used as chemoprophylaxis for the pregnant woman; there are some data to suggest pregnancy increases attraction of mosquitoes;
  4. There is a self diagnostic test for malaria available outside of the U.S.; the sensitivity and specificity in trials were > 90%, however, clinical experience suggests travelers don’t use the test correctly;
  5. MalaroneÒ is a relatively new anti-malarial with a cure rate of ³ 98% in non-immune persons with malaria; the dose is 4 tabs/day x 3 days in adults and 1-3 tabs/day x 3 days in children; the medication may induce vomiting so an antiemetic may be needed as well.