Prophylaxis for the states of Jammu and Kashmir, Himachal Pradesh and Sikkim
Malaria transmission is nil or very low in these states at a higher altitude. Routine chemoprophylaxis is therefore not essential for travelers to these states of the Indian Union. However it may be prudent to inquire about the ground situations by talking to the local medical professionals whenever possible.
Prophylaxis for all states other than Jammu and Kashmir, Himachal Pradesh and Sikkim and the North Eastern States of Assam, Manipur, Nagaland, Mizoram, Tripura and Arunachal Pradesh
The National Vector Borne Disease Control Programme (NVBDCP) recommends chemoprophylaxis for selective groups in high P. falciparum endemic areas. Use of personal protection measures including Insecticide Treated bed Nets (ITN) / Long Lasting Insecticidal Nets (LLIN) [See Personal protection measures] is encouraged for pregnant women and other vulnerable population including travellers for longer stay. However, for longer stay of Military and Para-military forces in high P. falciparum endemic areas, the practice of chemoprophylaxis should be followed wherever appropriate, e.g. troops on night patrol duty, and decisions of their Medical Administrative Authority should be followed.
For Short Term Prophylaxis (less than 6 weeks): Doxycycline, 100 mg daily in adults and 1.5 mg/kg for children more than 8 years old; it should be started 2 days before travel and continued for 4 weeks after leaving the malarious area. Doxycycline is contraindicated in pregnant women and children less than 8 years.
For long-term chemoprophylaxis (more than 6 weeks): Mefloquine 5 mg/kg bw (up to 250 mg) weekly; it should be administered two weeks before, during and four weeks after leaving the area. Mefloquine is contraindicated in cases with history of convulsions, neuropsychiatric problems and cardiac conditions.
Prophylaxis for States of Assam, Manipur, Nagaland, Mizoram, Tripura, Arunachal Pradesh
The north eastern states of India have higher incidence of chloroquine resistant P. falciparum malaria.
The National Vector Borne Disease Control Programme (NVBDCP) recommends chemoprophylaxis for selective groups in high P. falciparum endemic areas. Use of personal protection measures including Insecticide Treated bed Nets (ITN) / Long Lasting Insecticidal Nets (LLIN) [See Personal protection measures] is encouraged for pregnant women and other vulnerable population including travellers for longer stay. However, for longer stay of Military and Para-military forces in high P. falciparum endemic areas, the practice of chemoprophylaxis should be followed wherever appropriate, e.g. troops on night patrol duty, and decisions of their Medical Administrative Authority should be followed.
For Short Term Prophylaxis (less than 6 weeks): Doxycycline, 100 mg daily in adults and 1.5 mg/kg for children more than 8 years old; it should be started 2 days before travel and continued for 4 weeks after leaving the malarious area. Doxycycline is contraindicated in pregnant women and children less than 8 years.
For long-term chemoprophylaxis (more than 6 weeks): Mefloquine 5 mg/kg bw (up to 250 mg) weekly; it should be administered two weeks before, during and four weeks after leaving the area. Mefloquine is contraindicated in cases with history of convulsions, neuropsychiatric problems and cardiac conditions.
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