What is the recommended prophylaxis against malaria for this patient?

A 48-year-old woman is traveling to Haiti with a humanitarian aid group. What is the recommended prophylaxis against malaria for this patient?

  1. Atovaquone-proguanil
  2. Chloroquine
  3. Doxycycline
  4. Mefloquine
  5. Any of the above can be used

solution:

Malaria remains endemic in many parts of the world, and an estimated 30,000 travelers from the United States and Europe are infected with malaria during travel yearly. The areas of highest risk are in sub-Saharan Africa and Oceania with the lowest risk in South and Central America, including Haiti and the Dominican Republic. Chloroquine resistance is growing throughout the world and is especially notable in parts of South America, Africa, and Southeast Asia. However, in Haiti, the incidence of chloroquine resistant malaria is low. For a traveler to Haiti, the Centers for Disease Control and Prevention states that travelers have a choice of chloroquine, doxycycline, atovaquone– proguanil, or mefloquine. In addition, travelers should be cautioned to use appropriate techniques for malarial prevention, including protective clothing, DEET-containing insect repellants, permethrin-impregnated bednets, and screened sleeping accommodations, if possible.