Malaria Tablets: Are They Necessary For Bolivia Travel?

If you're planning a trip to Bolivia, it's important to consider the health risks and how to prevent them. Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. While there is no vaccine available, antimalarial tablets can help lower your chances of contracting the disease. The risk of malaria in Bolivia varies depending on the region, with high-risk areas such as the Amazon basin, Northern Beni, and Pando, and low-risk areas like Santa Cruz and Samaipata. It's essential to consult a healthcare professional for specific advice and to determine if you need antimalarial medication. They will consider your travel plans, medical history, and other factors to make an informed recommendation. Additionally, insect protection measures are crucial to avoiding mosquito bites and lowering your risk of malaria.

What areas of Bolivia are high risk for malaria?

The risk of contracting malaria is high in the Amazon region, in the department of Pando and the northern areas of the departments of Beni and La Paz. The risk is moderate in the regions below 2500 m, south of the high-risk areas in the department of Beni and in the northern part of the department of La Paz. The risk is low in areas below 2500 m, south of the moderate-risk areas in the department of Beni, the northern region of the department of Santa Cruz, and the eastern part of the department of Tarija. There is no malaria risk in the areas above 2500 m, including the cities of La Paz, Sucre, and Cochabamba.

In the high-risk areas, it is recommended to use mosquito-repellent measures from dusk till morning in combination with malaria tablets. In the moderate-risk areas, mosquito-repellent measures are also recommended from dusk till morning, and for people with an increased risk, preventive malaria tablets or emergency treatment may be advised. In the low-risk areas, mosquito-repellent measures are recommended from dusk till morning.

It is important to consult with a healthcare professional to determine if you need to take malaria tablets and to get advice on other measures to prevent mosquito bites.

What antimalarial medication should I take?

The antimalarial medication you should take depends on several factors, including your medical history, the areas of Bolivia you plan to visit, and the length of your stay. Here is some information to help you make an informed decision:

• The CDC recommends that travellers going to certain areas of Bolivia take prescription medication to prevent malaria. The specific medication and dosage will depend on your individual needs, so it is essential to talk to your doctor before your trip.
• Some of the commonly recommended antimalarial medications for Bolivia include Malarone, Maloff, Doxycycline, and Lariam (Mefloquine). These medications are typically advised for individuals visiting high-risk areas, such as the Amazon basin area, east of the Andes, especially Northern Beni and Pando.
• If you are travelling to low-risk areas of Bolivia, antimalarial medication is usually not necessary unless you have specific medical conditions or plan to stay in rural areas below 2500 metres for an extended period.
• It is important to start taking your chosen antimalarial medication multiple days before your trip, as directed by your doctor, and to continue taking it during and after your trip as prescribed.
• Be aware that antimalarial medications can sometimes cause side effects, so it is essential to discuss any concerns with your doctor before starting the medication.
• In addition to taking antimalarial medication, it is crucial to take precautions to avoid mosquito bites, such as using insect repellent, wearing long-sleeved clothing, and sleeping under a mosquito net.
• Remember that malaria can develop even up to a year after exposure, so if you experience any symptoms such as fever, chills, headaches, or muscle aches after returning from your trip, seek medical attention promptly and inform your doctor about your travel history.

What are the side effects of antimalarial tablets?

Antimalarial tablets are an effective way to prevent malaria infection when travelling to a region where malaria is widespread. However, like all medications, they can cause side effects. It is important to remember that side effects vary from person to person and not everyone will experience them.

Malarone, a commonly used antimalarial drug, has been associated with several side effects. The most common ones include headache, nausea, stomach pain, and diarrhoea. These side effects often improve as the body adjusts to the medication. Less common side effects of Malarone include dizziness, depression, sleeping problems, fever, an itchy rash, a cough, and decreased appetite.

Doxycycline, another antimalarial medication, is generally well-tolerated but may cause gastrointestinal issues such as an upset stomach, yeast infections in women, and increased sensitivity to sunlight.

Mefloquine, also known by the brand name Lariam, is an antimalarial drug that may cause side effects such as nausea, dizziness, vision problems, and anxiety. It has also been linked to more serious mental health side effects, including anxiety, vivid dreams, depression, and tinnitus.

Primaquine, a weekly antimalarial drug, may cause upset stomach as a side effect.

While rare, allergic reactions to antimalarial medications can occur. Signs of an allergic reaction include difficulty breathing, swelling of the face, lips, tongue, or eyelids, and a widespread rash with blisters and peeling skin. If you experience any of these symptoms, seek immediate medical attention.

It is important to weigh the risks and benefits of taking antimalarial medication when travelling to a malaria-endemic region. While side effects may occur, the risk of contracting malaria without proper prevention is far more serious and can be life-threatening.

How can I prevent mosquito bites in Bolivia?

Insect-borne diseases, particularly those transmitted via mosquitoes, can be a concern when travelling in Bolivia. The mosquito is most commonly found in low-lying tropical regions of Bolivia, such as Eastern Bolivia and the Bolivian Amazon. The risk of being bitten is highest at altitudes below 2,500m, especially during the rainy season from November to April.

• Cover exposed skin by wearing long-sleeved shirts, long pants, hats, and shoes.
• Use insect repellent containing DEET, Picaridin, or oil of lemon eucalyptus on exposed skin and clothing. The higher the percentage of DEET, the longer it lasts.
• Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). Do not use permethrin directly on the skin.
• Stay and sleep in air-conditioned or screened rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.
• Be vigilant about covering up and reapplying repellent, as mosquitoes tend to bite all day long. The main feeding times are just after sunrise and before sunset, so take extra care during these times.

What should I do if I develop a fever after travelling in a malarial area?

Malaria is a serious and potentially fatal disease. If you develop a fever after travelling in a malarial area, seek immediate medical attention and inform the doctor about your travel history. It is important to act quickly as malaria can get worse very rapidly and lead to severe complications.

If you are still in a malarial area, remember that malaria symptoms typically begin within a few weeks after being bitten by an infected mosquito, but in some cases, they may take up to a year to appear. Therefore, it is crucial to remain vigilant even after returning home.

While travelling in a malarial area, it is essential to take precautions to avoid mosquito bites. Here are some steps you can take:

• Cover your skin by wearing long-sleeved shirts and long pants. Tuck in your shirt and tuck your pant legs into your socks.
• Use insect repellent on exposed skin, containing ingredients such as DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), or para-menthane-3,8-diol (PMD). Do not use sprays directly on your face and avoid products containing OLE or PMD on children under three years old.
• Apply insect repellent to your clothing. Sprays containing permethrin are safe for this purpose.
• Sleep under a mosquito net, preferably one treated with insecticides such as permethrin.
• Stay in air-conditioned or well-screened rooms.

Additionally, consider taking antimalarial medication as a preventive measure. Consult a healthcare professional or travel health clinic to determine the most suitable antimalarial drug for your specific needs, based on factors such as your travel destination, medical history, and medication allergies. It is important to start taking the medication before your trip and continue during and after your stay in the malarial area as directed by your healthcare provider.

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