A 40-year-old engineer is posted for six months to a district in central Africa with intense chloroquine-resistant falciparum transmission. He has no contraindications to any antimalarial. Which chemoprophylactic regimen is appropriate?
- A Doxycycline 100 mg daily, started 1 to 2 days before entry and continued 4 weeks after leaving ✓
- B Chloroquine 300 mg base once weekly
- C Primaquine 15 mg daily throughout the stay
- D Artemether-lumefantrine one course monthly
Correct answer: A. Doxycycline 100 mg daily, started 1 to 2 days before entry and continued 4 weeks after leaving
Explanation
In areas with chloroquine-resistant falciparum malaria, doxycycline 100 mg daily is a standard prophylactic option, begun 1 to 2 days before travel and continued for 4 weeks after departure. Chloroquine is ineffective against resistant strains, artemisinin combinations are treatment drugs and are never used for prophylaxis, and primaquine is used mainly as terminal prophylaxis against relapse and is unsafe without G6PD testing.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
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