RFI: Malaria prophylaxis (2)
----------------------------
The British National Formulary No. 35, March 1998 recommends for sub-
Saharan Africa including Ethiopia (very high risk):- preferably Meflo-
quine 250mg once weekly OR Chloroquine 300mg base once weekly WITH Pro-
guanil hydrochloride 200mg once daily.
Mefloquine provides better protection and is recommended for visits
longer than 2 weeks. Fansidar should be reserved for treatment only as
it has dangers of:
1. reactions(sulphonamide) and
2. resistance with long term use.
Mefloquine is undoubtedly a nasty drug. It is the old case of balancing
risks. Remember all other protection activities: impregnated bed nets
and repellent with sensible clothing. Personally I would opt for Chlo-
roquine and Proguanil and keep the Mefloquine for treatment if there is
breakthrough infection. It should not be used for both prophylaxis and
treatment.
Good luck!
Ian Kennedy
mailto:ike@nildram.co.uk
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