In Cambodia, Laos and Myanmar (formerly Burma) malaria is resistant to many drugs, including mefloquine, so people who work or spend substantial periods of time in this area should take regular doxycycline or possibly Malarone. Overland travelers who go backpacking in northern Thailand near the Myanmar border have a low but significant risk of contracting malaria. If you are traveling in this area you should take either doxycycline or Malarone, or take all possible precautions against being bitten (a preventative measure that can also help you avoid other mosquito-transmitted diseases like dengue fever or Japanese encephalitis. The latter is almost always fatal, or in cases of recovery results in permanent brain damage. A vaccine is available.).
To avoid mosquito bites, take the following precautions:
- Wear light-colored clothing, especially white and creams--dark colors attract mosquitoes
- After dark ensure to have long pants, long sleeves, and covered shoes when in areas with mosquitoes
- Consider using a DEET-based repellent when going into the jungles, camping, or other times where the risk of mosquitoes are high
- Try to stay in upper-story hotel and hostel rooms, and try to get places with screened windows
- If roughing it, consider bringing your own mosquito net; when staying in jungle huts, et cetera, try to find places with mosquito nets if you do not have your own. When camping, be conscientious about closing your tent immediately after entering or exiting.
What is really means is that you need to go to a reputable clinic and also ensure you get name brand product (it will still be less than generic drugs in the USA or Europe, and your doctor's appointment is usually less that $20 USD). Most clinics will not stock malaria prophylactics, however, which means you need to call ahead and ensure they offer these medications. It is best to only get your malaria medication from a hospital clinic rather than a prescription to have filled outside the hospital.
You must call ahead, however, and know where and when you will be getting your malaria medication; ensure they stock the appropriate medications. Doxycycline is one of the most effective and broad spectrum malaria medications available. Chloroquine phosphate, Hydroxychloroquine sulfate, Chloroquine phosphate, Mefloquine, Primaquine, and Atovaquone/proguanil are some of the others.
A doctor will need to see you and then prescribe the best medicine for you considering the area(s) you are going to travel in. It is a good plan to figure our which malaria medication that you need beforehand, however, and if the doctor prescribes a medication you were not expecting, ask him or her to explain the decision. They may have their reasons; some malaria medications must be started weeks before potential exposure or be kept up weeks after return. Malaria can incubate for a year in some cases before one knows one has contracted the illness.
A good guide book like the Lonely Planet can help you find a hospital on your itinerary where you can get malaria medications: just ensure you call these places and verify ahead that they do. No one wants to get sick with a potentially life-threatening disease while traveling or vacationing; a few simple precautions can help insure you get to have fantastic adventures without such risks.