Africa Travel Advice

Friday Sound-Off: Are Antimalarial Medications Worth Taking?


Malaria is caused by the Plasmodium parasite that is carried by some mosquitoes.

It is a question that I have asked myself a few times before traveling internationally.  Do I take an antimalarial and deal with the sickness that is often a side-effect, or do I forgo the antimalarial and increase my odds of getting Malaria?  The answer to that question seems pretty straight-forward, and it probably is.  However, you would be surprised at how many people actually choose to not take an antimalarial before their trip.

According to the Centers of Disease Control and Prevention, roughly half the world’s population (or close to 3.2 billion people) live in areas that put them at risk of contracting Malaria.  And in 2016, roughly 216 million people contracted the disease and roughly 445,000 people died from its effects.  That just shows you how huge of an issue Malaria is, especially in Africa where roughly 91% of the deaths from Malaria occur.

CDC Map.png

A map that shows the level of Malaria risk throughout the world.

So with statistics that show just how wide-spread and devastating Malaria can be, why is there even discussion about not taking an antimalarial before traveling to a high-risk area of the world?  There are a several reasons that I have read people give that can be summarized as follows:

  • The side effects of the antimalarial makes me sick (most common reason).
  • I am using mosquito netting or an insect repellent, so I should be fine.
  • I don’t have the time or money to get the antimalarial.
  • Antimalarial medication isn’t guaranteed effective.  If I get sick, I will deal with it when I get back.

It’s an important topic, and I want you all to be aware of the discussions that are out there, so I have included some links to some recent articles and discussions I have read online.

I can certainly understand the reasoning behind some of these reasons for not taking an antimalarial when you travel, but I don’t necessarily agree with any of them.

On Side Effects

It is quite common for some of the antimalarial medications that are out there to make you feel nauseous when you take them.  This is more true for some than others, but they all have certain side effects that you have to deal with.  The CDC has an amazing chart that you can refer to before choosing which antimalarial will be best for you.  They also have an amazing chart that lists important Malaria related information by country.

Even though there are some side effects to antimalarial medications, these side-effects pale in comparison to the devastating effects of Malaria.  Instead of completely avoiding antimalarial medications, I think the much smarter approach is to talk to your doctor about your concerns and find the antimalarial that gives you the least amount of side-effects.  They each effect people differently and you need to know which is best for you.

On Preventative Measures

In regards to using mosquito netting, insect repellent, and other preventative measures, they can be effective in limiting exposure to malaria carrying mosquitoes.  However, they should not be considered alternatives to taking an antimalarial.  All it takes is one mosquito bite to transmit the disease.  So while limiting your exposure by using mosquito netting, insect repellent, and wearing long sleeve shirts is a great idea, these measures should be used in addition to taking an antimalarial if you are visiting a high-risk area.

On Cost and Time

I really sympathize with those who worry about the cost of acquiring an antimalarial before they travel.  Some of these medications can be quite costly, and sometimes they are not covered by insurance.  I have much less sympathy for those who say they can’t find the time to see a doctor about getting an antimalarial.  This should be a high priority when traveling to a high-risk area.

I do think that we need to find a way to make these medications much more available and affordable to all.  Malaria is one of the biggest health threats world-wide, and eradicating this terrible disease should be a priority.  Until that day comes when the risk is gone, I would suggest that you do everything possible to find a way to work it into your trip finances.  It really is important and should be a high priority.

On Not Being 100% Effective

Finally, I have read more than a few times about people who have chosen not to take an antimalarial before they travel because the antimalarial medications aren’t 100% effective.  Instead, they have opted to travel without an antimalarial and indicated that they would deal with it when they get home if they get sick.  Many of these individuals have traveled to high-risk areas in the past and have been fine, so it seems they have become desensitized to the issue.

While it is true that no antimalarial medication is 100% effective, they absolutely do reduce your risk of serious illness should you get infected.  I liken this decision to wearing a seat belt when you drive.  Are they guaranteed to save your life if you get in an accident?  No, but they are certainly going to reduce your risk of injury if you do get in a wreck.  We would strongly suggest that you take the pills.  You are much safer if you do.

Your Thoughts?

What are your thoughts on antimalarial medications?  Do you always take one when you travel to high risk areas?  If you don’t, why have you chosen not to?  If you do take them, what medication have you typically chosen to take, and did you experience any side-effects?  We would love to hear your opinions on this topic.  So please, leave us a comment.

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4 replies »

  1. About ten years ago we visited a part of Brazil that was supposedly malaria-free. Anti-malarials were not needed, and we were happy not to have to take them – although we hadn’t had any really bad reactions to any that we had taken previously. We used insect repellent, and after going for a swim, I got a lot of mosquito bites.
    About a week after returning home, my husband got sick. We thought it was flu, or perhaps the effects of working alternate evenings in a warm, humid, smelly (ammonia) environment – which was when he seemed to be worst – although after a while he was ok again. After a week of this, I took him to the doctor. He had a malarial episode right there in front of her. It was the worst one he’d had, and was not pleasant to see either. Fortunately it was treatable.
    So, I would say please take the pills if they are recommended. I know they’re not 100% guaranteed against contracting the disease, but anything that reduces your risk has to be worthwhile. There is no way of knowing who will get infected – I was the one that got the most bites.

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