Malaria: prophylaxis and therapy

Malaria remains a significant cause of morbidity and mortality in many regions of the world. In Singapore, an average of 200 cases of malaria have been reported annually, the majority of which are imported cases. Malaria eradication is a goal that may not be achieved. A more realistic aim is to educate and protect individual travellers. This paper attempts to summarise various therapeutic options including the use of monotherapy and combination therapy. The decision on therapy depends on several factors, such as the Plasmodium species, risk of transmission of the resistant parasite and the severity of infection. So far, none of the chemoprophylactic regimens available can provide an absolute protection from malaria transmission. Therefore, one needs to assess the risk of transmission against the potential risk of adverse drug reaction. Complications of anti-malaria drugs may range from minor cutaneous manifestations to death. General measures to prevent vector transmission of the disease should be emphasised while awaiting the development of an effective malaria vaccine.