To prevent malaria, attention must be paid to reducing risk factors (in this case, exposure prophylaxis).
Behavioral risk factors
- Insufficient protection against mosquito bites in malaria areas.
Other risk factors
- Airport malaria (synonyms: aircraft or airport malaria) – infection on the plane or at the airport by imported mosquitoes.
- Baggage malaria – infection by mosquitoes from flight baggage.
- Very rarely, transmission can occur through blood bags or shared injection systems; needle stick injuries can also occur as transmission
- Diaplacental infection (infection “through the placenta” or “across the placenta”) from the mother to the unborn child can occur
Preventive measures (protective measures)
The following measures should be implemented for individual prophylaxis:
- Detailed medical consultation before travel.
- Implementation of exposure prophylaxis, ie mosquito protection v. especially at dusk and at night:
- Stay in mosquito-proof rooms (air conditioning, fly screens) during twilight / night.
- Sleeping under mosquito nets (impregnated with insecticidal substances).
- Wearing appropriate (if necessary impregnated) clothing (long-sleeved blouses and shirts, long pants, socks).
- Use of repellents (relative protection!)
- Implementation of chemoprophylaxis in malaria areas with high transmission potential. In areas with low or medium malaria risk, a reserve drug (see below “Chemoprophylaxis of malaria”) should be carried. This should be taken in case of malaria-suspicious symptoms and if medical help cannot be reached (stand-by).Note: In general, malaria prophylaxis is no longer necessary when listening to the radio above 1,500 meters. However, depending on temperature and precipitation, transmission may occur even in favorable environmental conditions above 2,000 m.
- In malaria endemic areas, it is best not to be outdoors during twilight and night time.
- Pregnant women should generally be advised to postpone travel to malaria endemic areas until after pregnancy.
- For children, malaria prophylaxis should primarily consist of consistent exposure prophylaxis (mosquito nets over beds and play areas). Chemoprophylaxis is possible, but the lower dosage according to the manufacturer’s instructions should be observed.
Prevention factors (protective factors)
- Malaria tertiana: Duffy-negative trait carriers are resistant to Plasmodium vivax parasites because the altered receptor prevents contact with the host cell. The Duffy factor is both an antigen and a receptor for Plasmodium vivax. Notice: Plasmodia from Madagascar and Cambodia have now been detected in which the gene for the “Duffy-binding protein” is duplicated, which could facilitate cell invasion by the parasites. However, the loss of Duffy protection could also have other causes. Thus, another gene mutation may also be responsible.
- Infection with Plasmodium falciparum (malaria tropica): survival advantage in blood group 0.
- Malaria tropica: carriers of the blood group Dantu, which occurs in East Africa, fall ill 40% less often. This blood group characteristic is based on a change in the protein glycophorin, which serves as an anchor for entry into the erythrocytes by the malaria pathogen Plasmodium falciparum.
