Doxycycline

What is Doxycycline?

Doxycycline is a broad-spectrum antibiotic used in the treatment of many infections including respiratory tract infections, urinary tract infections, infections spread by infected animals, and certain types of skin infections.

Doxycycline is also used to prevent malaria and is very effective as a prophylactic agent in areas with multi-drug resistant malaria. To effectively prevent malaria, the treatment should start 1-2 days before traveling and only one capsule should be taken per day.

What is Malaria?

Malaria is a mosquito-borne blood disease caused by an infected mosquito bite. When bitten, the parasite transfers to the bloodstream and infect in the red blood cells and/or liver, causing malaria. Malaria is a serious disease that can be life-threatening.

Directions for Doxycycline use

The dose of Doxycycline varies according to the intended use.
For malaria prophylaxis, you should start treatment 1-2 days before travelling to any malaria-endemic area (the area where malaria is common).

• Take one capsule of Doxycycline 100 mg once daily 1-2 days before travelling
• Take one capsule daily during all travelling period
• Continue taking Doxycycline for 4 weeks after returning
• Take the daily capsule with a full glass of water

Avoid

• Doxycycline may increase your skin sensitivity to sunlight, don’t expose to sunlight for a long time.
• Don’t take Doxycycline with any dairy products like milk, yoghurt or cheese.
• Don’t take Doxycycline just before bed and don’t lie down for 30 minutes after taking it as well.

Other medication

If you are taking any of the following medications, you should take Doxycycline 2 hours before, or 6 hours after taking them

• Antacids containing magnesium, calcium or aluminium
• Iron supplements
• Laxatives containing magnesium
• Calcium supplements

• Is Malaria a contagious disease?

  No. Malaria is not spread directly from person to person, and it cannot be transmitted sexually. 

• How do I know if I have malaria for sure?

  The surest way to know is to have a diagnostic blood test (your blood examined for the presence of malaria parasites and especially for people who have recently traveled to malaria-endemic areas without previous taking of prophylactic antimalarial drugs.  

• How can I protect myself while traveling to an area with Malaria?

  You have to choose effective prophylactic antimalarial drugs and take it one week before exposure.

• Is there a Malaria vaccine and why?

  No, it is not. Because of the Malaria is a complex organism with a complicated life cycle and there are ongoing researches for the vaccine.

• How malaria infection occurs?

  When the infected female mosquito bites the bare skin, the parasites enter your body and then travel to your liver and your red blood cells. The parasite then uses the red blood cells as a method of transport to different body organs and systems.

  Malaria can infect infants before birth, by infected and untreated pregnant mothers. Malaria during pregnancy increases infant mortality, causes abortion, and causes intrauterine growth retardation.

• Who is at risk of becoming infected with malaria?

  Any person can be infected with Malaria. The majority of cases occur in endemic areas. Those travelling to countries with malaria can be infected easily, so, they need to be protected by antimalarial drugs which are effective and available before traveling.  

  The dose of prophylaxis for adults; one week before exposure to the risk of malaria infection, you have to take two tablets (5mg base/kg for children) once a week until four weeks after leaving the dangerous area.

  You should adjust the does with your doctor if you have kidney or liver problems.

• What are the potentially undesirable effects of Atovaquone | Proguanil and Malarone?

  Atovaquone/ Proguanil and Malarone less side effects than other antimalarial drugs. May cause;

  -                   Allergies in form of rashes

  -                   Headache

  -                   Abdominal pain

  -                   , nausea, diarrhea, and dizziness

• Can I use Atovaquone | Proguanil and Malarone during pregnancy and lactation?

  Atovaquone/ Proguanil and Malarone should not be used during pregnancy but can be used during the first trimester. As for lactation, it is not recommended with Atovaquone | Proguanil and Malarone use.

• What are the potentially undesirable effects of Avloclor or Resochin?

  May include:

  -                   Vomiting, Diarrhea, and nausea.

  -                   Low blood pressure

  -                   Headache

  -                   Abdominal pain

• Can I use Avloclor or Resochin during pregnancy and lactation?

  No, Avloclor and Resochin should not be used during pregnancy or lactation.

• How can I use Atovaquone | Proguanil and Malarone?

  Take one tablet per day with food or milk for prophylaxis. Start the treatment 1-2 days before traveling to high risk areas and for one week after leaving. For treatment of Malaria, take 4 tablets daily for 3 days. In case of vomiting within 1 hour of the dose, you have to repeat the dose. In the case of the children, the dose has to be adjusted according to the weight of the child.

• How can I use Avloclor and Resochin?

  Avloclor and Resochin 250 mg tablets are used for treatment, prophylaxis, and suppression of all species of Malaria. Avloclor is the active ingredient of chloroquine. It is short course effective treatment and prevention against dangerous malaria. Take it after food.

  
  The dose of treatment for adults; one single dose of four tablets (10mg base/kg for children), after six hours, take the 2nd does of two tablets ((5mg base/kg for children) and then two tablets (5mg base/kg for children) a day for two days.

What causes Malaria

Malaria is a life threating disease caused by a parasite (Plasmodium protozoa). Infection occurs in tropical areas predominantly. The parasite is transmitted to humans through the bite of a female mosquito (Anopheles). There are five species of Plasmodium that can cause malaria in human.

5 types of Plasmodium parasite cause malaria in human

1. Plasmodium falciparum – Found in Africa, it's the most common type of malaria parasite and is responsible for the highest malaria deaths around the world 
2. Plasmodium vivax – Found in South America and Asia, this parasite causes milder symptoms than, but can stay alive in the human liver for up to 3 years, which can cause cycles of Malaria.  
3. Plasmodium Ovale – Not as common as the above 2,  and can be found in West Africa, this Plasmodium can remain in your liver for several years and not you may not show any signs.
4. Plasmodium Malariae – Rare and mostly only found in Africa 
5. Plasmodium knowlesi – Very rare and mostly found in some areas of southeast Asia

How is Malaria spread

The female mosquito parasite spread the Plasmodium parasites. These mosquitoes are known to the locals as “night-biting” mosquitos, as they are known for biting humans between dusk and dawn, hence why you sleep with nets protecting the body in malaria danger zones.

Spread both ways 

If a human is already infected with malaria, and a mosquito bites the human, the mosquito can then become infected itself with the Plasmodium parasite and spread the parasite on to other humans.

After a bite

Once the mosquito bites a human, the parasite enters the bloodstream of the human and travels to the liver. Where the plasmodium multiplies and grows in number, before entering the bloodstream again and entering the red blood cells of the human. The parasites grow further in number and size when inside the red blood cells. The blood cells will burst due to the parasite infection and them back in the bloodstream.  This occurs every 2-3 days, and the human will feel fever symptoms such as chills and sweating.  

Other methods of transmission

A point to note is malaria can also spread through blood transfusions, and sharing of needles, but this rarely occurs.

Side effects of Doxycycline

• Increased sensitivity to sunlight – use high factor sunscreen (Spf50+)
• Gastrointestinal side effects are the most common side effects of Doxycycline, such as diarrhoea, nausea, vomiting, and stomach upset.
• Vaginal yeast infection
• Sore tongue
• Inflammation of the liver or bowel

If any of these side effects worsen or doesn’t go away, talk to your healthcare provider.

Alarm side effects - stop taking Doxycycline if:

The following side effects may be an alarm sign for serious conditions

• Headache
• Blurred vision
• Eye swelling,
• Skin peeling,
• Unusual bleeding,
• Joint pain,
• Watery or bloody stool.

If you experience any of these symptoms you should talk to your doctor immediately.