10 Tips For Preventing Malaria
Every year thousands of travelers, including many children, return from the tropics with a souvenir they did not bargain for: malaria, a disease that can almost always be prevented.
Here is what you have to know:
1. Understand malaria.
The disease is caused by a microscopic parasite that is transmitted to humans by the bite of infected anopheles mosquitoes. Four species of parasites cause disease in humans. The parasite makes its way through the skin and into the blood stream, 
enters red blood cells, multiplies, and destroys the blood cells. Mosquitoes acquire theparasite by biting humans already infected, and ingesting blood containing parasites.
2. Know where malaria exists.
If you are going to a tropical country, check ifmalaria is present. Lists of such countries can be found on the CDC website: http://wwwn.cdc.gov/travel/yellowBookCh4-Malaria.aspx and in books on travel medicine.
3. If you intend to visit a country where malaria exists, speak to your physician.
The disease is rarely present in an entire country.While malaria exists in Mexico and the Dominican Republic, it does so only in remote parts rarely visited by travelers. In other countries, it is found only in rain forests, below certain altitudes, in the rainy season, or in rural areas, not in cities.
4. Preventing insect bites is your primary defense.
See “Protecting children from insect bites” and “Using insect repellents on children” for the very latest information on these subjects.
5. Medications are your secondary defense.
You need expert opinion to make medication decisions. Medications commonly used include chloroquine, mefloquine, atavaqone/proguanil, and doxycycline. No single medication is universally effective. Choice depends on the age of the child, the species of parasite present, and to which medications those parasites are susceptible, for example.
6. Understand how medication is given.
Some anti-malarials are taken daily, others weekly. Some must be started several weeks before exposure, others just a day or two before. And medication must be continued after exposure ends, some for a week, others for four weeks.
7. Understand dosing.
In the U.S., no liquid formulation exists; only pills. (Liquid preparations available overseas vary in concentration and are best avoided.) Doses for children are calculated by body weight. For smaller children, pills must be divided into smaller segments. This is best done by first pulverizing pills and then dividing the powder. Ask your pharmacist for assistance. Check doses carefully; overdoses can have serious side effects in small children.. Store pills away from children to avoid accidental ingestion.
8. Know tricks for administering medication.
The powder has a bad taste. The taste can be disguised by mixing the powder with strawberry jam or chocolate syrup. Giving doses on a full stomach may minimize stomach upset and vomiting. Know what to do if your child refuses the medication, vomits immediately, or you forget to administer a dose. (Keep the telephone numbers of your doctors handy.)
9. Protect newborns.
Infants have no natural immunity to malaria and are as likely to be bitten as other age groups. Medications are available which are safe for infants. Breast milk of mothers taking anti-malarials does not protect infants.
10. Think malaria if your child has a fever while in malarial areas or in the monthsafterwards.
Very rarely, malaria occurs even when you observe protective measures and use medication as prescribed. If your child has a fever with no obvious cause, seek medical care immediately. A simple blood test at a reliable medical facility makes the diagnosis. Tell doctors your recent travel history if a family member becomes ill in the months after returning home. Malaria can surface months later. Malaria is a treatable disease if diagnosed promptly.
