Article information
La malaria representa para los viajeros la primera causa infecciosa de riesgo de complicaciones graves y muerte. Su adquisición durante un viaje depende de la zona geográfica visitada, la especie parasitaria predominante, la frecuencia de resistencia a los antipalúdicos y de la realización de las medidas de prevención. A la espera de una vacuna, la estrategia de prevención descansa en la información al viajero, el uso de medidas barrera que limiten las picaduras de los vectores, la toma de quimioprofilaxis de manera adecuada y la posibilidad del autodiagnóstico y autotratamiento. La elección de la pauta de quimioprofilaxis ha de hacerse de manera individualizada, ya que ninguna pauta garantiza un 100% de protección y ninguna está exenta de efectos tóxicos secundarios o contraindicaciones. Doxiciclina, atovacuona-proguanil y mefloquina son los fármacos más eficaces; mientras que atovacuona-proguanil y doxiciclina son los que con menos frecuencia producen efectos secundarios graves
Palabras clave:
Viaje
Malaria
Prevención
Profilaxis
Malaria prevention in international travel For travelers malaria represents the principal infectious risk of severe complications and death. Infection during traveling depends on the geographical area visited, the predominant species of parasite, the frequency of resistance to antimalarial agents, and whether preventive measures have been taken. Until a vaccine has been developed, prevention strategies consist of providing travelers with information, the use of barrier methods against vector bites, the correct use of chemoprophylaxis, and the possibility of self-diagnosis and treatment. The choice of chemoprophylaxis regimen should be individualized since no regimen guarantees 100% protection or is free of adverse effects or contraindications. The most effective drugs are doxycycline, atovaquone-proguanil and mefloquine while those producing severe adverse effects with the least frequency are atovaquone-proguanil and doxycycline
Key words:
Travel
Malaria
Prevention
Prophylaxis
Full text is only aviable in PDF
Bibliografía
[2.]
P. Muentener, P. Schlagenhauf, R. Steffen.
Imported malaria (1985-95): Trends and perspectives.
Bull World Health Organ, 77 (1999), pp. 560-566
[3.]
V. Rotaeche, G. Henández, S. Mateo.
Vigilancia epidemiológica del paludismo en España: 1996-1999.
Bol Epidemiol Semanal, (2001), pp. 21-25
[4.]
R. López-Vélez, A. Viana, C. Pérez-Casas, J. Martín-Aresti, M.C. Turrientes, A. García-Camacho.
Clinicoepidemiological study of imported malaria in travelers and immigrants to Madrid.
J Travel Med, 6 (1999), pp. 81-86
[5.]
D.O. Freedman, J. Woodall.
Emerging infectious diseases and risk to the traveler.
Med Clin North Am, 83 (1999), pp. 865-883
[6.]
R. López-Vélez, A. García Camacho.
Malaria, África y viajes: un triángulo de riesgo.
Rev Clin Esp, 198 (1998), pp. 494-495
[7.]
T. Jelinek, H.D. Nothdurft, T. Loscher.
Malaria in Nonimmune Travelers: A Synopsis of History, Symptoms, and Treatment in 160 Patients.
J Travel Med, 1 (1994), pp. 199-202
[8.]
J. Bradley, D. Warhurst, M. Blaze.
Malaria imported into the United Kingdom in 1996.
Euro Surveill, 3 (1998), pp. 40-42
[9.]
M.S. Fradin, J.F. Day.
Comparative efficacy of insect repellents against mosquito bites.
N Engl J Med, 347 (2002), pp. 13-18
[10.]
B.A. Conner.
Expert recommendations for antimalarial prophylaxis.
J Travel Med, 8 (2001), pp. S57-S64
[11.]
P. Schlagenhauf.
Mefloquine for malaria chemoprophylaxis 1992-1998: A review.
J Travel Med, 6 (1999), pp. 122-133
[12.]
Croft AM, Garner P. Mefloquine for preventing malaria in non-immune adult travellers. Cochrane Database Syst Rev 2000:CD000138
[13.]
P. Schlagenhauf, A. Tschopp, R. Johnson, H.D. Nothdurft, B. Beck, E. Schwartz, et al.
Tolerability of malaria chemoprophylaxis in non-immune travellers; a randomized, double-blind, four arm study.
Acta Tropica, 83 (2002), pp. S39
[14.]
J. Keystone, P. Kozarsky.
Closing the circle.
pp. 510-515
[15.]
K.C. Kain, G.D. Shanks, J.S. Keystone.
Malaria chemoprophylaxis in the age of drug resistance. I. Currently recommended drug regimens.
Clin Infect Dis, 33 (2001), pp. 226-234
[16.]
G.D. Shanks, K.C. Kain, J.S. Keystone.
Malaria chemoprophylaxis in the age of drug resistance. II. Drugs that may be available in the future.
Clin Infect Dis, 33 (2001), pp. 381-385
[17.]
G.D. Shanks, P.G. Kremsner, T.Y. Sukwa.
Atovaquone and proguanil hydrochloride for prophylaxis of malaria.
J Travel Med, 6 (1999), pp. 21-27
[18.]
J. Ling, J.K. Baird, D.J. Fryauff, P. Sismadi, M.J. Bangs, M. Lacy, et al.
Randomized, Placebo-Controlled Trial of Atovaquone/Proguanil for the Prevention of Plasmodium falciparum or Plasmodium vivax Malaria among Migrants to Papua, Indonesia. PG - 825-33.
Clin Infect Dis, 35 (2002), pp. 825-833
[19.]
T.A. Shapiro, C.D. Ranasinha, N. Kumar, P. Barditch-Crovo.
Prophylactic activity of atovaquone against Plasmodium falciparum in humans.
Am J Trop Med Hyg, 60 (1999), pp. 831-836
[20.]
B. Hogh, P.D. Clarke, D. Camus, H.D. Nothdurft, D. Overbosch, M. Gunther, et al.
Atovaquone-proguanil versus chloroquine-proguanil for malaria prophylaxis in non-immune travellers: A randomized, double-blind study. Malarone International Study Team.
Lancet, 356 (2000), pp. 1888-1894
[21.]
D. Overbosch, H. Schilthuis, U. Bienzle, R.H. Behrens, K.C. Kain, P.D. Clarke, et al.
Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: Results from a randomized, double-blind study.
Clin Infect Dis, 33 (2001), pp. 1015-1021
[22.]
R.A. Kuschner, D.G. Heppner, S.L. Andersen, B.T. Wellde, T. Hall, I. Schneider, et al.
Azithromycin prophylaxis against a chloroquine-resistant strain of Plasmodium falciparum.
Lancet, 343 (1994), pp. 1396-1397
[23.]
S.L. Anderson, J. Berman, R. Kuschner, D. Wesche, A. Magill, B. Wellde, et al.
Prophylaxis of Plasmodium falciparum malaria with azithromycin administered to volunteers.
Ann Intern Med, 123 (1995), pp. 771-773
[24.]
W.R. Taylor, T.L. Richie, D.J. Fryauff, H. Picarima, C. Ohrt, D. Tang, et al.
Malaria prophylaxis using azithromycin: A double-blind, placebo-controlled trial in Irian Jaya, Indonesia.
Clin Infect Dis, 28 (1999), pp. 74-81
[25.]
Heppner D, Wongsrichanalai C, Walsh DS. Azithromycin for the prophylaxis of malaria in Thailand. Proceedings of the 48th Annual Meeting of the American Society of Tropical Medicine and Hygiene, nov 28-dec 2, 1999
[26.]
C. Orth, G.D. Willingmyre, P. Lee, C. Knirsch, W. Millous.
Assessment of azithromycin in combination with other antimalarial drus against Plasmodium falciparum in vitro.
Antimicrob Agents Chemother, 46 (2002), pp. 2518-2524
[27.]
W.R. Weiss, A.J. Oloo, A. Johnson, D. Koech, S.L. Hoffman.
Daily primaquine is effective for prophylaxis against falciparum malaria in Kenya: Comparison with mefloquine, doxycycline, and chloroquine plus proguanil.
J Infect Dis, 171 (1995), pp. 1569-1575
[28.]
C. Ohrt, T.L. Richie, H. Widjaja, G.D. Shanks, J. Fitriadi, D.J. Fryauff, et al.
Mefloquine compared with doxycycline for the prophylaxis of malaria in Indonesian soldiers. A randomized, double-blind, placebo-controlled trial.
Ann Intern Med, 126 (1997), pp. 963-972
[29.]
S.L. Andersen, A.J. Oloo, D.M. Gordon, O.B. Ragama, G.M. Aleman, J.D. Berman, et al.
Successful double-blinded, randomized, placebo-controlled field trial of azithromycin and doxycycline as prophylaxis for malaria in western Kenya.
Clin Infect Dis, 26 (1998), pp. 146-150
[30.]
D. Baudon, G. Martet, B. Pascal, J. Bernard, A. Keundjian, R. Laroche.
Efficacy of daily antimalarial chemoprophylaxis in tropical Africa using either doxycycline or chloroquine-proguanil; a study conducted in 1996 in the French Army.
Trans R Soc Trop Med Hyg, 93 (1999), pp. 302-303
[31.]
G.D. Shanks, P. Roessler, M.D. Edstein, K.H. Rieckmann.
Doxycycline for malaria prophylaxis in Australian soldiers deployed to United Nations missions in Somalia and Cambodia.
Mil Med, 160 (1995), pp. 443-445
[32.]
J.D. Arthur, P. Echeverría, G.D. Shanks, J. Karwacki, L. Bodhidatta, J.E. Brown.
A comparative study of gastrointestinal infections in United States soldiers receiving doxycycline or mefloquine for malaria prophylaxis.
Am J Trop Med Hyg, 43 (1990), pp. 608-613
[33.]
R. Steffen, E. Fuchs, J. Schildknecht, V. Naef, M. Funk, P. Schlagenhauf, et al.
Mefloquine compared with other malaria chemoprophylactic regimens in tourists visiting east Africa.
Lancet, 341 (1993), pp. 1299-1303
[34.]
H.O. Lobel, M. Miani, T. Eng, K.W. Bernard, A.W. Hightower, C.C. Campbell.
Long-term malaria prophylaxis with weekly mefloquine.
Lancet, 341 (1993), pp. 848-851
[35.]
N. Muehlberger, T. Jelinek, U. Schlipkoeter, F. Von Sonnenburg, H.D. Nothdurft.
Effectiveness of chemoprophylaxis and other determinants of malaria in travellers to Kenya.
Trop Med Int Health, 3 (1998), pp. 357-363
[36.]
A.P. Hopperus Buma, P.P. Van Thiel, H.O. Lobel, C. Ohrt, E.J. Van Ameijden, R.L. Veltink, et al.
Long-term malaria chemoprophylaxis with mefloquine in Dutch marines in Cambodia.
J Infect Dis, 173 (1996), pp. 1506-1509
[37.]
H.O. Lobel, J.K. Varma, M. Miani, M. Green, G.D. Tood, K. Grady, et al.
Monitoring for mefloquine-resistant Plasmodium falciparum in Africa: implications for travelers’ health.
Am J Trop Med Hyg, 59 (1998), pp. 129-132
[38.]
M.R. Wallace, T.W. Sharp, B. Smoak, C. Iriye, P. Rozmajzl, S.A. Thornton, et al.
Malaria among United States troops in Somalia.
Am J Med, 100 (1996), pp. 49-55
[39.]
E. Boudreau, B. Schuster, J. Sánchez, W. Novakowski, R. Johnson, D. Redmond, et al.
Tolerability of prophylactic Lariam regimens.
Trop Med Parasitol, 44 (1993), pp. 257-265
[40.]
P.J. Barrett, P.D. Emmins, P.D. Clarke, D.J. Bradley.
Comparison of adverse events associated with use of mefloquine and combination of chloroquine and proguanil as antimalarial prophylaxis: Postal and telephone survey of travellers.
BMJ, 313 (1996), pp. 525-528
[41.]
P. Schlagenhauf, R. Steffen.
Neuropsychiatric events and travel: Do antimalarials play a role?.
J Travel Med, 7 (2000), pp. 225-226
[42.]
Schlagenhauf P, Abo El, Ela H, Niederberger W. Drug safety database analysis of the events suicide, attempted suicide and suicidal ideation reported in association with the use of Lariam(r) chemoprophylaxis, Proceedings of the ISTM Conference, Innsbruck, may 27-31, 2001
[43.]
P.A. Phillips-Howard, D. Wood.
The safety of antimalarial drugs in pregnancy.
Drug Saf, 14 (1996), pp. 131-145
[44.]
B. Vanhauwere, H. Maradit, L. Kerr.
Post-marketing surveillance of prophylactic mefloquine (Lariam) use in pregnancy.
Am J Trop Med Hyg, 58 (1998), pp. 17-21
[45.]
B.L. Smoak, J.V. Writer, L.W. Keep, J. Cowan, J.L. Chantelois.
The effects of inadvertent exposure of mefloquine chemoprophylaxis on pregnancy outcomes and infants of US Army servicewomen.
J Infect Dis, 176 (1997), pp. 831-833
[46.]
J.K. Baird, D.J. Fryauff, H. Basri, M.J. Bangs, B. Subianto, I. Wiady, et al.
Primaquine for prophylaxis against malaria among nonimmune transmigrants in Irian Jaya, Indonesia.
Am J Trop Med Hyg, 52 (1995), pp. 479-484
[47.]
J.K. Baird, M.D. Lacy, H. Basri, M.J. Barcus, J.D. Maguire, M.J. Bangs, et al.
Randomized, parallel placebo-controlled trial of primaquine for malaria prophylaxis in Papua, Indonesia.
Clin Infect Dis, 33 (2001), pp. 1990-1997
[48.]
D.J. Fryauff, J.K. Baird, H. Basri, I. Sumawinata, T.L. Purnomo Richie, et al.
Randomized placebo-controlled trial of primaquine for prophylaxis of falciparum and vivax malaria.
Lancet, 346 (1995), pp. 1190-1193
[49.]
J. Soto, J. Toledo, M. Rodríguez, J. Sánchez, H. Herrera, J. Padilla, et al.
Double-blind, randomized, placebo-controlled assessment of chloroquine/primaquine prophylaxis for malaria in nonimmune Colombian soldiers.
Clin Infect Dis, 29 (1999), pp. 199-201
[50.]
E. Schwartz, G. Regev-Yochay.
Primaquine as prophylaxis for malaria for nonimmune travelers: A comparison with mefloquine and doxycycline.
Clin Infect Dis, 29 (1999), pp. 1502-1506
[51.]
B. Lell, J.F. Faucher, M.A. Missinou, S. Borrmann, O. Dangelmaier, J. Horton, et al.
Malaria chemoprophylaxis with tafenoquine: A randomized study.
Lancet, 355 (2000), pp. 2041-2045
[52.]
G.D. Shanks, A.J. Oloo, G.M. Aleman, C. Ohrt, F.W. Klotz, D. Braitman, et al.
A new primaquine analogue, tafenoquine (WR 238605), for prophylaxis against Plasmodium falciparum malaria.
Clin Infect Dis, 33 (2001), pp. 1968-1974
[53.]
CDC. Health information for international travel 2001-2002: US Department of Health and Human Services, Atlanta, 2001
[54.]
WHO. International Travel and Health. Situation as on 1 Juanary 2002: World Health Organization, Genève, 2002
[55.]
WHO. International Travel and Health. Situation as on 1 Juanary 2001: World Health Organization, Genève, 2001
[56.]
D.J. Bradley, B. Bannister.
Guidelines for malaria prevention in travellers from the United Kingdom for 2001.
Commun Dis Public Health, 4 (2001), pp. 84-101
[57.]
R.A. Pennie, G. Koren, C. Crevoisier.
Steady state pharmacokinetics of mefloquine in long-term travellers.
Trans R Soc Trop Med Hyg, 87 (1993), pp. 459-462
[58.]
T. Weinke, M. Trautmann, T. Held, G. Weber, D. Eichenlaub, K. Fleischer, et al.
Neuropsychiatric side effects after the use of mefloquine.
Am J Trop Med Hyg, 45 (1991), pp. 86-91
[59.]
P. Rendi-Wagner, H. Noedl, W.H. Wernsdorfer, G. Wiedermann, A. Mikolasek, H. Kollaritsch.
Unexpected frequency, duration and spectrum of adverse events after therapeutic dose of mefloquine in healthy adults.
Acta Trop, 81 (2002), pp. 167-173
[61.]
P.A. Matson, S.P. Luby, S.C. Redd, H.R. Rolka, R.A. Meriwether.
Cardiac effects of standard-dose halofantrine therapy.
Am J Trop Med Hyg, 54 (1996), pp. 229-231
[62.]
T. Jelinek, M.P. Grobusch, H.D. Nothdurft.
Use of dipstick tests for the rapid diagnosis of malaria in nonimmune travelers.
J Travel Med, 7 (2000), pp. 175-179
[63.]
R.H. Behrens, C.J. Whitty.
Self-use of rapid tests for malaria diagnosis.
Lancet, 355 (2000), pp. 237
[64.]
A. Bjorkman, P.A. Phillips-Howard.
Drug-resistant malaria: mechanisms of development and inferences for malaria control.
Trans R Soc Trop Med Hyg, 84 (1990), pp. 323-324
[65.]
C. Wongsrichanalai, A.L. Pickard, W.H. Wernsdorfer, S.R. Meshnick.
Epidemiology of drug-resistant malaria.
Lancet Infect Dis, 2 (2002), pp. 209-218
[66.]
K.H. Rieckmann, D.R. Davis, D.C. Hutton.
Plasmodium vivax resistance to chloroquine?.
Lancet, 2 (1989), pp. 1183-1184
[67.]
I.K. Schwartz, E.M. Lackritz, L.C. Patchen.
Chloroquine-resistant Plasmodium vivax from Indonesia.
N Engl J Med, 324 (1991), pp. 927
[68.]
G.S. Murphy, H. Basri, E.M. Purnomo Andersen, M.J. Bangs, D.L. Mount, et al.
Vivax malaria resistant to treatment and prophylaxis with chloroquine.
Lancet, 341 (1993), pp. 96-100
[69.]
E.J. Phillips, J.S. Keystone, K.C. Kain.
Failure of combined chloroquine and high-dose primaquine therapy for Plasmodium vivax malaria acquired in Guyana, South America.
Clin Infect Dis, 23 (1996), pp. 1171-1173
[70.]
J.K. Baird, I. Wiady, D.J. Fryauff, M.A. Sutanihardja, B. Leksana, H. Widjaya, et al.
In vivo resistance to chloroquine by Plasmodium vivax and Plasmodium falciparum at Nabire, Irian Jaya, Indonesia.
Am J Trop Med Hyg, 56 (1997), pp. 627-631
[71.]
D.J. Fryauff, S. Tuti, A. Mardi, S. Masbar, R. Patipelohi, B. Leksana, et al.
Chloroquine-resistant Plasmodium vivax in transmigration settlements of West Kalimantan, Indonesia.
Am J Trop Med Hyg, 59 (1998), pp. 513-518
[72.]
L. Signorini, A. Matteelli, F. Castelnuovo, F. Castelli, O. Oladeji, G. Carosi.
Short report: Primaquine-tolerant Plasmodium vivax in an Italian traveler from Guatemala.
Am J Trop Med Hyg, 55 (1996), pp. 472-473
[73.]
B.L. Smoak, R.F. DeFraites, A.J. Magill, K.C. Kain, B.T. Wellde.
Plasmodium vivax infections in U.S. Army troops: Failure of primaquine to prevent relapse in studies from Somalia.
Am J Trop Med Hyg, 56 (1997), pp. 231-234
[74.]
J.D. Maguire, I.W. Sumawinata, S. Masbar, B. Leksana, P. Prodjodipuro, I. Susanti, et al.
Chloroquine-resistant Plasmodium malariae in south Sumatra, Indonesia.
Lancet, 360 (2002), pp. 58-60
Copyright © 2003. Elsevier España, S.L.. Todos los derechos reservados
