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Malaria Prevention and Control Doxycycline 100mg Taken daily, start 1-2 days Areas where prior entry to risk area, chloroquine and -Malaria is both an acute and chronic disease caused by protozoa of the genus continue daily dosing while at mefloquine resistant Plasmodium. There are 4 species that can cause human malaria: P. falciprum, area and 4 wks after leaving. P. falciprum exists P.vivax, P. malariae, and P. ovale. Malaria is transmitted to humans by the bite Daily dosing should be taken of an infected female Anopheles mosquito. P. falciprum is the most serious and the same time each day. Mefloquine (Lariam) Taken weekly, start 1-2 wks Areas where fatal type of Malaria. 228 mg base (250 mg prior entry to risk area, chloroquine resistant salt) continue weekly dosing while P. falciprum exists -The complex life cycle of Malaria is divided into 4 unique phases: at area and 4 wks after leaving Exoerythrocytic Phase, Hypnozoite Phase, Erythrocytic Phase, and Vector Chloroquine 300 mg Taken weekly, start 1-2 wks Areas where Phase. base (500 mg salt) prior entry to risk area, chloroquine resistant continue weekly dosing while P. falciprum has NOT at area and 4 wks after leaving been reported Atovaquone+ Taken daily, start 1-2 days Areas where Proguanil (Malarone) prior entry to risk area, chloroquine and 250mg/100mg continue daily dosing while at mefloquine resistant area and 7 days after leaving. P. falciprum exists C. Terminal Prophylaxis – Primaquine is the only available medication that can prevent the liver stages of malaria from P. vivax and P. ovale. Before taking primaquine, however, it is critical to verify G-6-PD deficiency. G-6-PD deficient individuals should only take primaquine under the direction of an infectious diseases specialist. Please note the above chart. Terminal prophylaxis with doxycycline, mefloquine and chloroquine lasts for four weeks after departure from the endemic area. During the final two weeks of that terminal prophylaxis, a 14-day course of 30 mg daily primaquine should be taken Preventive measures include: simultaneously to prevent the liver stage of P. vivax and P. ovale. For A. Personal protective measures- Application of DEET, treatment of individuals taking atovaquone & proguanil, the 14 day Primaquine clothing with Permethrin, and appropriate netting are measures that can course should be started the first day after leaving risk area. effectively provide disease vector protection. B. Chemoprophylaxis- Refers to the administration of a medication for D. Unit Protective Measures- Inform the command and its personnel of the purpose of preventing disease or infection. Prophylactic treatment the risk of Malaria through training of the importance of personal should begin 2 weeks prior travel to endemic area, except doxycycline, protective measure and chemoprophylaxis. which should begin 1-2 days prior exposure. Prophylaxis should be Reference: Navy Environmental Health Center (Technical Manual NEHC-TM PM continued throughout the time of visitation and 4 weeks after leaving 6250.1(2007)) endemic area.
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