Question: I have G6pd [Editor’s note: this stands for glucose-6-phosphate dehydrogenase deficiency]. Will I be able to take malaria medication? What do I have to do to ensure I will not have a reaction to drugs and how safe is it for me? I am planning a trip to China and Cambodia next year. There are other areas I want to travel also with malaria. I did not know I had this until I ate fava beans and it ate my red blood cells. I almost died from this and was given 4 pints of red blood plasma in the year 2000.
Answer: Thanks for the question, as you raise an important concern. The main form of malaria medication that is not recommended for people G6PD deficiency is primaquine. The good news is that it is not commonly used as a preventive medication for malaria, and the more frequently used preventive medication options should be safe for you to take (though please consult with your physician ahead of time). Specifically for China and Cambodia, either atovaquone-proguanil (commonly sold under the brand name Malarone) or doxycycline are suitable forms of preventive medication. The US CDC has more detailed information per country, including descriptions about which parts of the country are at risk from malaria. This information is available on the CDC Malaria Information by Country.
Primaquine is most commonly used to treat two specific types of malaria: P. vivax and P. ovale. These species of malaria can take on a form that hides in the liver and causes relapsing malaria, months or even years after the initial infection; primaquine is the drug used to kill these dormant liver stages and prevent relapse. If you happen to get infected with malaria, it will be very important to determine which species you have, as you may not be able to take primaquine. However, with effective prevention (taking the correct preventive medication, and protecting yourself from mosquito bites through wearing long-sleeved clothing, wearing insect repellent, and sleeping under a long-lasting insecticide-treated bednet), the risk of contracting malaria is very low.