Pharmacists advised to read updated malaria prevention recommendations
Pharmacists are being urged to read new malaria prevention guidelines published by the Health Protection Agency.
The updated guidelines, which contain specific recommendations for individual
countries, now have greater emphasis on mefloquine, doxycycline and atovaquone/
proguanil as the three options for highly chloroquine-resistant falciparum
malarious areas.
Dr Barbara Bannister, clinical head of service, infection and immunity
at the Royal Free Hospital, London, and one of the guideline authors
told The Journal that travellers may not realise their knowledge could
be out of date. “People may remember times when relatively simple
measures were effective, such as taking chloroquine once a week, but
the susceptibility of malaria to these regimens has diminished.” She
added: “If a patient goes into a pharmacy to buy chloroquine the
pharmacist is in an excellent position to check that chloroquine is the
correct drug for their destination.”
Writing in an editorial to accompany the guidelines, which are due to
be published in the journal Communicable Disease and Public Health (2003;6:180),
Dr Bannister says that widespread self-medication, which may include
suboptimal dosage and inadequate duration of treatment, leads to the
rapid emergence of drug resistance. She says that longer-term antimalarial
treatment is safe as long as contraindications such as pregnancy are
observed.
“Continuing prophylaxis can be confidently advised for those intending
to live or work long term in malaria endemic countries,” she writes.
Pharmacists are advised to read in particular the section of the guideline
that covers the health care workers’ consultation with prospective
travellers. This section includes information about the risks of getting
malaria and about malaria prevention.
Dr Bannister pointed out that people returning to malarious regions are
highly represented among cases of malaria diagnosed in the United Kingdom. “People
who originate from that area may feel they are resistant to malaria,
or may remember the country from a time when malaria was well controlled.”
The guidelines also note that pharmacists are entitled to make yellow
card reports to the Medicines and Healthcare products Regulatory Agency
of adverse events believed to be related to use of antimalarials. Dr
Bannister commented: “It is important for pharmacists to know that
catching malaria when on prophylactic treatment counts as an adverse
event.”
The guidelines can be accessed here. |
