Taking along an antimalarial drug fora traveler visiting an endemic area ca
n be a good idea in the event of a suspected malarial illness while abroad.
This stand-by medication should be prescribed before departure to a travel
er compliant with protective measures against mosquitoes. This curative dru
g is indicated either for short but repeated exposures (aircrews) or for a
minimal stay of one week in a place where diagnostic and therapeutic facili
ties are more than 12 hours away. Other factors which determine the need fo
r stand-by medication include the risk of acquiring malaria infection, depe
nding on both the level of vectorial transmission and the indication or not
of a chemoprophylaxis. To choose the drug for stand-by treatment, the foll
owing points must be examined:
- the type and intensity of chemoresistance of Plasmodium falciparum in the
visited area,
- the concomitant use of a chemoprophylactic regime,
- the traveler's health status,
- the efficacy and toxicity of available drugs.
According to the few reported surveys, many travelers take along a drug for
emergency treatment, which they use at a slightly higher rate than the est
imated malaria risk would require in the visited area. The future of stand-
by treatment mostly depends on the availability of a reliable and simple se
lf-diagnosis test and of a new antimalarial drug, both efficient and safe.
(C) 1999 Editions scientifiques et medicales Elsevier SAS.