Malaria in PNG

Malaria is a significant problem throughout PNG and is a major risk in the major cities and also in the more remote jungle regions. Whilst it was once thought that it was too cold in the PNG highlands for the malaria transmitting mosquitos to breed, this is definitely not true. The plasmodium falciparum species is responsible for more than 85% of malaria cases in PNG however both plasmodium vivax and plasmodium malariae species are also occasionally reported. The mosquito that transmits malaria is small and frequently not noticed when biting.

Malaria Prevention

Prevention of mosquito bites is by far the most effective method for preventing malaria infection and this involves:

• wearing long sleeve shirts and long pants – particularly in the afternoon and evening when the mosquito is most active
• Applying DEET based mosquito repellent (Bushman’s is a good brand) – this should be applied first thing in the morning and then reapplied at lunch time and then again in the evening
• Clothes and sleeping bag liners can be soaked in pyrethrin prior to departing for your trek (see your local trekking supplies store)
• Sleep in a tent with mosquito netting

Doxycycline. One tablet each day for one week prior to departure until four weeks after returning home. The most common side effects are heartburn/reflux and exaggerated sunburn response. Be sure to apply adequate sunscreen if using doxycycline. This medication is also an antibiotic and theoretically provides protection against wound infections and possibly even against diarrhoeal illness (although the diarrhoea bacteria are mostly resistant).

Mefloquine (Lariam). One tablet each week starting 1 - 2 weeks prior to departure until four weeks after returning home. Mefloquine's main advantage is its once-weekly dosing. Side effects include nightmares, insomnia and nausea. It can rarely lead to psychiatric disturbances and seizures. Trekkers taking beta-blocking cardiac medication, those allergic to quinine or with a history of seizures should not use mefloquine.

Atovaquone/proguanil (Malarone). Malarone is a newer combination tablet taken once daily for two days prior to departure until one week after returning home. Malarone can occasionally cause nausea, vomiting, diarrhoea, abdominal pain and headaches, although side effects are usually mild.

The most effective method of malaria prevention is to avoid mosquito bites. Liberal use of insect repellant and tents with mosquito netting are essential.