Do I need antimalarial tablets for Goa?

There is no definitive answer to this.  Advice varies over time and individual countries advise their citizens differently. The aim here is to put some context to the conflicting advice found on travel forums and even government websites.  We don’t have any medical expertise and so would encourage you to visit a doctor or practice nurse about 4 weeks before travelling.

MIXED MESSAGES

Malaria in Goa only became an issue in the late 1970’s and it has a since proven difficult to advice travellers due to its variable nature. For example in the UK the Health Protection Agency (HPA) in 2003 decided to stop recommending malaria chemoprophylaxis for travellers to Goa following a continued downward trend.  In 2007 they reversed this decision due to a reported outbreak and have not changed their position since.

Other EU countries have reacted differently. For example German speaking countries have mostly held with not recommending taking antimalarial tablets for Goa, but are that keen travellers have access to treatment or carry emergency kits should they show symptoms. There’s an excellent academic paper which justifies the German position.

THE PRESENT SITUATION

Presently the situation in Goa is relatively good. Last year the Times of India wrote:

 In 2007, 9,755 malaria cases were detected in Goa but by 2010 the department managed to control and bring the number down to 2,368. In 2012 about 1,714 cases of malaria were detected whereas during last four months 197 cases have been reported.  

This year there is an optimism that Malaria in Goa can be eradicated within five years.  Previously in 2009 a Malaria Elimination Network was formed and although did not achieve its aims to have no malaria by 2012 much of this has been down to an increase in construction work.

An important thing to understand about Malaria in Goa is that most of  it (recently over 90%) is Plasmodium vivax which antimalarial tablets are less effective against as it has a dormant phase in the liver. What antimalarials are 90% effective at preventing is Plasmodium falciparum which is much more deadly.  Certainly, when the UK to reverted their decision in 2007  it was in response to cases of western travellers returning with Plasmodium falciparum.  However, given the huge drop in the number of P. falciparum cases since 2007 the UK policy presently looks very cautious, but understandable as change creates confusion and attracts criticism.

YOUR SITUATION

Other factors that determine the need for antimalarials are your individual travel plans and health.  The risk of malaria greatly increases during the Monsoon session (June – Sept) and generally anywhere where pools of stagnant water can form. Recently around 85% of the malaria case in Goa have been found in migrant construction workers so be extra cautious if building work is going on near you.

Naturally your accommodation and activities are key to determining your risk. We wrote a post on avoiding mosquito bites, but doing this along with recognising the flu like symptoms of malaria are absolutely essential.

We are not going to talk about the range of antimaterial tablets available here. This is a large topic with differences of professional opinion (even at a national level). However as they all carry some potential side effects, your health will also determine the type of antimalarial advised, if indeed, any is at all.

HAVE YOU HAD EXPERIENCE OF TAKING ANTIMALARIALS ?

Are you one of the 85% of people who travel without any precautionary drugs or do you prefer to play it safe ?


2 Comments

  1. Alex Reeves 24 September, 2013 at 2:35 pm #

    Hey David, we just saw this article tweeted by someone in the UK on http://www.malariapp.com.

    It’s interesting that the Times of India article you linked to said that people do not take the symptoms seriously. This kind of problem relates to Sonia Shah’s recent TED talk where she laid out the cultural issues of fighting malaria. More specifically she mentioned how the attitude towards malaria was a problem, as people living in high risk areas didn’t take the disease (or fighting to eradicate it) seriously.

    Great article guys and it was awesome to see it tweeted.