Traveling in Malaria Endemic Countries: How to Keep Yourself Safe

by Hannah Harrison

They can cause more than an itch. Image from Pixabay.

The headache struck in the middle of the night, pounding mercilessly right behind my eyes.

As a person who rarely gets headaches, and certainly never the kind that a dose of ibuprofen can’t fix, this incessant pain kept me awake until the wee hours of the morning.  I must be dehydrated, I thought to myself.

I finished off my water bottle and went to fill it again, staggering to my hut’s water filter under the pressure of this unwelcome pain. I chased a dose of generic pain killer with another liter of water and waited for the pain to subside.  An hour ticked by as I sat in the dark, massaging my temples.

No change.

The ache spread through my body as the day progressed, and by mid-afternoon I could feel myself burning up and shaking with the chills.

Oh no, I thought.  Malaria.

In Peace Corps countries where malaria is endemic, our medical staff go to great lengths to prepare volunteers with anti-malarial measures.

–We sleep under Peace Corps-issued mosquito nets

–We take regular doses of anti-malaria medication

–We are encouraged to wear long sleeves and bug repellent when working in mosquito infested areas or at night.

Foreigners to endemic areas are especially prone to the disease (as are the old, the infirm, and the young) because they were raised in malaria-free countries and don’t possess the local low-grade immunity to the malaria infection.

Sitting in my hut, riddled with body pain and dreading the results of my home malaria test, I couldn’t understand how it was possible that I was ill.

–I take my anti-malaria drugs every morning without fail

–I am normally headed to bed not long after dark

–I am a fervent believer in mosquito nets as they have the added bonus of keeping all manner of creepy-crawlies out of my bed

Still, here I was, struck low by Africa’s #1 killer of children under the age of five. Thankfully, Peace Corps took action and got me the medication necessary to cure my malaria infection.  Without their rapid response and medical intervention, the ending to this story could have been a lot less pleasant.

But not everyone has access to a 24-hour medical officer during their travels.

So, what should a Wanderful woman do to keep herself safe when traveling to malaria endemic countries?

Here are a few tips to make sure your trip doesn’t land you in the hospital:

1. Have your physician recommend you an anti-malarial medication, and take it as directed, without fail.

Most travelers use the general antibiotic Doxycycline, which is readily available in many countries.  It can make you more photosensitive (Read: Wear your sunscreen) and must be taken with food each day at the same time.

I use Malarone, which is also a daily medication but doesn’t cause photosensitivity.  I am careful to take it around the same time each day and always with a meal to help protect my stomach.  Malarone is becoming a much more popular anti-malarial drug, but it is harder to find and sometimes more expensive than Doxy.

Mefloquine is the biggest and baddest of the common anti-malarial drugs.  Taken once per week, it offers the most effective protection against malarial infection and has the most leeway if you forget to take it on time.  However, Mefloquine also can cause a whole host of unpleasant side effects ranging from vivid dreams to, in very rare cases, psychotic disorders.  As with all medications, consult your doctor to choose one that is right for you.

2. Insist on bed nets, and make sure they will work!

When choosing your lodging, make sure your accommodation offers bed nets that are generally free of major holes and will fit entirely around the bed so that you may tuck the free ends in. Some bed nets are treated with pesticides to help reduce the mosquito population and so may be irritating to bare skin if they rub you in the night.  Arrange your bed net to fit comfortably around your bed, tuck it in once you’re inside, and arrange yourself to sleep without any bare skin touching the net.

One example of a bed net. Image from Wikimedia Commons.
One example of a bed net. Image by Infrogmation from Wikimedia Commons.

3. Wear bug repellent and long sleeves, especially at night.

In Africa the mosquitoes that carry the malaria parasite bite at night, and especially around dusk and dawn.  Remember, all it takes is one bite to start an infection. Be diligent in wearing bug repellent, and choose protective clothing in dark colors to help minimize the amount of skin available for a mosquito to bite.

What tips and tricks do you currently use to keep yourself healthy abroad?  Share your ideas in the comments!  Want to read more about life in the Peace Corps in Africa? Check out my blog at

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