Malaria is the common name of human infections caused by four species of parasites. Other names for malaria, particularly used in European countries, are "Paludism" or "Paludeen fever".

Malaria is a worldwide problem for the two thirds of the world's population living in malarious areas. A conservative estimate is that there are 220 million new infections a year. In Africa alone, malaria causes over a million deaths each year.

Although Singapore is safe from malaria, precautions must be taken when traveling to rural areas within Southeast Asia.

The problem has become worse in recent years due to increasing resistance to pesticides by mosquitoes and increasing resistance to medication by the malaria parasites.

All four types of the malaria parasites are transmitted by mosquitoes of the genus Anopheles. Most fatal infections are caused by P.falciparum and are more likely to occur when diagnosis and treatment are delayed or inappropriate.

How can one avoid malaria infections?

If you are planning a trip to an endemic area, you should be aware of the following:

1. Malaria is spread by mosquitoes which bite mainly at dusk and throughout the night.

2. Any measures that reduce mosquito bites reduce the risk of contracting malaria, dengue fever and filariasis. Avoid perfumes and colognes. Use insect sprays, mosquito nets and screens, and wear clothing with long sleeves and long pants.

Use insect repellents containing at least 30 percent diethyltoluamide (Deet), especially during evening and night hours (please note that Deet can cause severe reactions particularly with prolonged or excessive use in children or in higher concentrations). Spraying clothing with permethrin (Permanone) and using permethrin-impregnated mosquito nets may also help.

3. For prophylactic drugs to be effective they must be taken regularly.

4. Prophylactic medication does not offer absolute protection against malaria.

5. Exceeding the recommended dosage of prophylactic medicine does not increase its effectiveness and may actually increase the risk of side effects.

What type of anti-malaria prophylaxis is recommended?

This is a difficult and controversial area, but all international experts agree that some form of prophylaxis is necessary. In areas when there is no resistance to anti-malaria medication, chloroquine is sufficient. However, chloroquine resistance (primarily falciparum type) occurs in many places in the world and most of Southeast Asia.

Prescription drugs in these areas include mefloquine (Lariam), doxycycline and Malrarone (a newer anti-malaria drugs).

Before leaving one's country for a malarious area, it is best to consult with your doctor or government health department for specific recommendations concerning the use of these anti-malaria medications.