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IV Balearic Meeting of European Residents and GP of IBAMFIC
The GP as an Educator for Travelers on Chemoprophylaxis
FÓTHY, Julio Francisco; CONDE-VALVIS FRAGA, Sara
MeSH Keywords: Chemoprophylaxis, Endemic, Malaria
- 35-year-old male, native from Ghana, living in Europe for the last 7 years returns from his country.
- Made a Chloroquine chemoprophylaxis, finishing early 2 weeks before coming back.
- 2 weeks after arriving he starts with nausea (no vomiting), anorexia, headache and high temperature with shivering.
Physical examination:
- Temp 38.2°C - Respiratory auscultation: NAD
- HR 98 bpm - Normal abdomen: No hepatosplenomegaly
- BP 126/77 mmHg - No Lymphadeneopathy
- Overall preserved.
Malaria is suspecte
Referred to A&E:
- Thick blood film with Giemsa: 1.5% parasitized red blood cells.
- Antigen chromatography: Plasmodium falciparum vs. mixer infection.
- Full Blood Count, coagulation, renal function, urinalysis and electrolytes normal
- Gluc 120mg/dl, CPR 38.80mg/l; Lactate 0.92mmol/l; Total Bilirubin 2.44mg/dl; Direct Bilir 0.88mg/dl, ASAT 43; ALAT 61, GGT 80, alkaline
phosphatase 50U/L
Discharged the following day. Home treatment:
- Quinine sulfate 650 mg TDS + Doxycycline 100 mg BD for 7 days.
Conclusions:
- It is important to know that, because of its high resistance rate, chemoprophylaxis of choice for some Plasmodium falciparum endemic
areas (such as the exposed case) is NOT chloroquine (Resochin ®) but atovaquone 250mg+proguanil 100 mg (Malarone ®) or artenimol
40mg+piperaquine 320mg (Eurartesim ®) among others.
- It is essential to explain the importance of chemoprophylaxis to travelers to endemic areas: A complete course of chemoprophylaxis
must be assured (pre-, intra- and post-traveling), which should be stocked up before the trip starts. So the quality of the treatment is
assured and the purchase of circulating false drugs in endemic areas is also avoided.
- If chemoprophylaxis is rejected or there are contraindications there is the exceptional possibility of self-administered treatment, as
rescue on clinical suspicion, until professional health assistance is reached, with Malarone ® or Eurartesim ® among others, both available
in Europe.

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Malaria

  • 1. IV Balearic Meeting of European Residents and GP of IBAMFIC The GP as an Educator for Travelers on Chemoprophylaxis FÓTHY, Julio Francisco; CONDE-VALVIS FRAGA, Sara MeSH Keywords: Chemoprophylaxis, Endemic, Malaria - 35-year-old male, native from Ghana, living in Europe for the last 7 years returns from his country. - Made a Chloroquine chemoprophylaxis, finishing early 2 weeks before coming back. - 2 weeks after arriving he starts with nausea (no vomiting), anorexia, headache and high temperature with shivering. Physical examination: - Temp 38.2°C - Respiratory auscultation: NAD - HR 98 bpm - Normal abdomen: No hepatosplenomegaly - BP 126/77 mmHg - No Lymphadeneopathy - Overall preserved. Malaria is suspecte Referred to A&E: - Thick blood film with Giemsa: 1.5% parasitized red blood cells. - Antigen chromatography: Plasmodium falciparum vs. mixer infection. - Full Blood Count, coagulation, renal function, urinalysis and electrolytes normal - Gluc 120mg/dl, CPR 38.80mg/l; Lactate 0.92mmol/l; Total Bilirubin 2.44mg/dl; Direct Bilir 0.88mg/dl, ASAT 43; ALAT 61, GGT 80, alkaline phosphatase 50U/L Discharged the following day. Home treatment: - Quinine sulfate 650 mg TDS + Doxycycline 100 mg BD for 7 days. Conclusions: - It is important to know that, because of its high resistance rate, chemoprophylaxis of choice for some Plasmodium falciparum endemic areas (such as the exposed case) is NOT chloroquine (Resochin ®) but atovaquone 250mg+proguanil 100 mg (Malarone ®) or artenimol 40mg+piperaquine 320mg (Eurartesim ®) among others. - It is essential to explain the importance of chemoprophylaxis to travelers to endemic areas: A complete course of chemoprophylaxis must be assured (pre-, intra- and post-traveling), which should be stocked up before the trip starts. So the quality of the treatment is assured and the purchase of circulating false drugs in endemic areas is also avoided. - If chemoprophylaxis is rejected or there are contraindications there is the exceptional possibility of self-administered treatment, as rescue on clinical suspicion, until professional health assistance is reached, with Malarone ® or Eurartesim ® among others, both available in Europe.