What is Malaria?
Malaria is a potentially life-threatening disease caused by blood parasites of the genus Plasmodium, which are transmitted via the bites of infected mosquitoes. In the human body, the parasites first multiply in the liver, and then infect the red blood cells. Malaria is preventable and curable. Increased malaria prevention and control measures are dramatically reducing the malaria burden. Globally, malaria is one of the six major causes of deaths from communicable diseases. 90% of the world’s approximately 440 000 annual malaria deaths occur in Africa. In the last few years, (2015-2019) South Africa has had between about 10 000 and 30 000 notified cases of malaria per year, and the National Department of Health is planning to eliminate it (i.e. no local transmission) by 2023. However, there are increasing problems with importation of malaria cases, vector control spraying programme delivery, vector insecticide resistance, and many health provision challenges that stand in the way of this objective.
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Doxycycline for Malaria Prevention
The antibiotic doxycycline is one of the antimalarial agents recommended in South Africa for malaria chemoprevention. According to the latest consolidated schedule from the South African Health Products Regulatory Authority (SAHPRA), doxycycline is listed as Schedule 2 drug when intended and labelled for the chemoprophylaxis of malaria in individuals aged 8 years and older.
The drug can, therefore, be dispensed without a prescription to individuals travelling to malaria-endemic areas. To expand access to this chemoprevention tool and support South Africa’s malaria elimination agenda, doxycycline for malaria chemoprevention was added to the Primary Healthcare Level and Paediatric Hospital Level Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML) in January 2024.
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