BNF for Children 2011-2012

BNFC 2011–2012 5.4.1 Antimalarials 333November–June in other areas below 1200 m; risk negligiblein Harare and Bulawayo):mefloquine or doxycycline (if child over 12) orMalarone cNote In Zimbabwe and neighbouring countries, pyrimethaminewith dapsone (also known as Deltaprim c ) prophylaxis is usedby local residents (sometimes with chloroquine—this regimenis not recommended).under Great Risk, below), Vietnam (cities, coastbetween Ho Chi Minh and Hanoi, and Mekong Riveruntil close to Cambodian border; substantial risk inother areas, see below):chemoprophylaxis not recommended but avoidmosquito bites and consider malaria if fever presentsSouth AsiaLow risk Risk low in Bangladesh (but high risk inChittagong Hill Tracts, see below), India (Kerala [southernstates], Tamil Nadu, Karnataka, Southern AndhraPradesh [including Hyderabad], Mumbai, Rajasthan[including Jaipur], Uttar Pradesh [including Agra], Haryana,Uttaranchal, Himachal Pradesh, Jammu, Kashmir,Punjab, Delhi; variable risk in other areas, see below;high risk in Assam), Sri Lanka (but variable risk north ofVavuniya, see below):chemoprophylaxis not recommended but avoidmosquito bites and consider malaria if fever presentVariable risk Risk variable and some chloroquineresistance in Indonesia (very low risk in Bali, and citiesbut substantial risk in Irian Jaya [West Papua] andLombok, see below), rural Philippines below 600 m(no risk in cities, Cebu, Bohol, and Catanduanes), deepforests of peninsular Malaysia and Sarawak (but substantialrisk in Sabah, see below):chloroquine + proguanil hydrochloride or (ifchloroquine + proguanil not appropriate) mefloquineor doxycycline or Malarone cVariable risk Risk variable and chloroquine resistanceusually moderate in southern districts of Bhutan, India(low risk in some areas, see above; high risk in Assam,see below), Nepal (below 1500 m, especially Terai districts;no risk in Kathmandu), Pakistan (below 2000 m),Sri Lanka (north of Vavuniya; low risk in other areas, seeabove):chloroquine + proguanil hydrochloride or (ifchloroquine + proguanil not appropriate) mefloquineor doxycycline or Malarone cSubstantial risk Risk substantial and drug resistancecommon in Cambodia (no risk or very low risk in someareas, see above; great risk in western provinces, seebelow), China (Yunnan and Hainan; chloroquineprophylaxis appropriate for other remote areas; seealso Very Low Risk above), East Timor, Irian Jaya[West Papua], Laos (no risk in Vientiane), Lombok,Malaysia (Sabah; see also Very Low Risk and VariableRisk above), Myanmar (formerly Burma; see also GreatRisk below), Vietnam (very low risk in some areas, seeabove):mefloquine or doxycycline (if child over 12) orMalarone c5 InfectionsHigh risk Risk high and chloroquine resistance high inBangladesh (only in Chittagong Hill Tracts; low risk inother areas, see above), India (Assam only; see also LowRisk and Variable Risk above):mefloquine or doxycycline (if child over 12) orMalarone c or (if mefloquine, doxycycline, orMalarone c not appropriate) chloroquine + proguanilhydrochlorideGreat risk and drug resistance present Risk greatand widespread chloroquine and mefloquine resistancepresent in western provinces of Cambodia (see alsoVery Low Risk and Substantial Risk above), bordersof Thailand with Cambodia, Laos and Myanmar (verylow risk in Chang Rai and Kwai Bridge, see above),Myanmar (eastern Shan State):doxycycline (if child over 12) or Malarone cSouth-East AsiaVery low risk Risk very low in Bali, Brunei, Cambodia(Angkor Wat and Siem Reap, but no risk in Phnom Penh;substantial risk in other areas, see below; great risk inwestern provinces, see below), main tourist areas ofChina (but substantial risk in Yunnan and Hainan, seebelow; chloroquine prophylaxis appropriate for otherremote areas), Hong Kong, Korea (both North andSouth), Malaysia (both East and West including CameronHighlands, but substantial risk in Sabah [except KotaKinabalu], and variable risk in deep forests, see below),Singapore, Thailand (important: regional risk exists, seeOceaniaRisk Risk high and chloroquine resistance high inPapua New Guinea (below 1800 m), Solomon Islands,Vanuatu:doxycycline (if child over 12) or mefloquine orMalarone c