Malaria

Prevention

Transmitted by mosquito bites, the simplest and most effective way to prevent malaria is to avoid getting bitten.

Generally, there aren't all that many mosquitoes in Raja Ampat. Bungalows over the water usually are a good choice to avoid them. However, it's best to always sleep with a mosquito net.

Use insect repellent and maybe think of wearing long and light-coloured clothes, especially when heading into the mangroves or the forest. Mosquitoes are most active during dawn and dusk, there is not much

Mosquitoes are most active during dawn and dusk, there is not much to worry about during the day, especially when on the water.

Chemoprophylaxis

For travellers with short-term exposure to the threat of malaria, chemo-prevention is worth thinking about. To learn more about the recommended drug and dosage for the area you want to visit, talk to a tropical medicine specialist.

Vaccine

There is a malaria vaccine - tradename Mosquirix - available, but it has only been tested in Africa and has a low efficacy of around 30%.

Transmission

Malaria is transmitted by mosquitos of the genus Anopheles. In order to carry the infection, they previously must have bitten an infected person. This makes it less likely to transmit the disease in sparsely populated areas like Raja Ampat - cities like Sorong are a different story.

There are around 40 species of the Anopheles mosquito, that carry the Plasmodium parasites - some of which also transmit the pathogens for Elephantiasis .

The average incubation period is 11 days, but may range from 9 to 30 days - make sure to keep that in mind when you get sick back home after a visit to Raja Ampat.

Treatment

Of the five Malaria-pathogens, two are common in Raja Ampat and West Papua. An accurate diagnosis without a blood test is impossible.

Plasmodium Vivax

Although it is less virulent than Plasmodium Falciparum, Vivax-Malaria infections can lead to severe disease and death, often due to splenomegaly.

Traditionally, Chloroquine is the treatment of choice for Vivax-Malaria, but the increasing drug-resistance (over 20%) has become a problem in West Papua. Alternative treatments are Artesunate, Primaquine, Atovaquone-Proguanil, Tafenoquine and Mefloquine. Often a combination treatment with some of these is necessary to avoid the patient relapsing.

Plasmodium Falciparum

This is the deadliest species of Plasmodium that causes malaria in humans.

The WHO's recommendation are Artemisinin-based combination therapies ACTs, such as:

• Artemether + Lumefantrine
• Artesunate + Amodiaquine or Mefloquine or Sulfadoxine-Pyrimethamine
• Dihydroartemisinin + Piperaquine

If the above don't work, an alternative ACT is recommended:

• Artesunate + Tetracycline or Doxycycline or Clindamycin
• Quinine + Tetracycline or Doxycycline or Clindamycin