ROLE OF TRAVEL MEDICAL KIT: TYPES OF PRODUCTS TO RECOMMEND:

 Helps one stay comfortable and safe & take care of oneself
 Compact yet with enough storage room for the necessary items
 Cater for the individual, geographical environment, and activities to be
carried out
 Need to know what items in the kit are used for and how to use them

FACTORS TO CONSIDER:

 Travel itinerary  Current medical conditions

 Budget
 Age of travellers
 Medicines available at pharmacy
 Medicines available at home
 Start date of travel
(Choice of malaria prophylaxis?)
 Patient’s preference
 Allergies
 Current medications
 Living Conditions (rural?)
 Quantity of medicines
 Sharing medications?

COMMON HEALTH CONCERNS WHEN ABROAD:

 Traveller’s diarrhoea  Sunburn

 Motion Sickness  Insect Bites
 Minor ailments  Malaria
(cough / cold / fever)
 Medicines for - Cough, Cold, Pain, Fever

L05: TRAVEL MEDICAL KIT

minor ailments - Gastrointestinal
- Eye, ear, nose, oral health
- External rubs / creams
Surgicals - Masks, plasters
- Hygiene items (e.g. disinfectant)
- Patient compliance aids (pillbox)
- Others (e.g. First aid kits)
Personal Care - Skin care (Sunscreens / Moisturisers)
Lifestyle - Travel pillows
- Water purification tablets
- Travel compression socks
- Jet lag pills
- Motion sickness remedies

OCCURRENCE OF MALARIA: PREVENTIVE MEASURES:

 Mainly transmitted in tropical and subtropical areas
- Warmer regions closer to the equator:
- transmission will be more intense;
- malaria is transmitted all year-round
 Transmission is unlikely to occur:
- at very high altitudes;
- during colder seasons in some areas;
- in deserts (excluding the oases);
- in some countries where transmission has been interrupted
through successful control / elimination programmes
Avoid mosquito bites by:
 Sleep in rooms that are screened with gauze over windows and
doors / air-conditioned rooms.
 Spray the room with insecticide before entering to kill any
mosquitoes that may have gotten inside during the day.
 Put a mosquito net around the bed, impregnated with insecticide.
 Wear long trousers, long-sleeved clothing and socks thick enough
to stop the bites especially after sunset.
 Wear light-coloured clothing.
 Avoid using perfume as strong scents attract mosquitoes.
 Apply insect repellent on exposed skin areas.

SIGNS & SYMPTOMS OF MALARIA: All these precautions should be taken, especially at twilight & at night.
Physical Findings: Symptoms:
- Elevated Temperatures - Fever

L05: MALARIA PROPHYLAXIS

-
-
-
Perspiration
Increased respiratory rate
Mild jaundice
-
-
-
Headaches
Chills
Sweats
- Enlarged liver - Nausea & Vomiting
- Enlarged spleen - Body Aches Using Insect Repellents:
- Weakness - General malaise
Mosquito repellent containing diethyl toluamide (DEET) is
recommended as the most effective form of bite-preventive treatment.
RISK FACTORS:  It has an excellent safety profile in adults, children
(> 2 months old), pregnant and breastfeeding women.
 Living or travelling in a country/region where malaria is common
 For young children or those with delicate skin,
 Not using malaria prophylaxis, or taking the medicine wrongly
use patches (on clothing) to avoid potential skin irritation.
 Being outdoors, especially in rural areas, between dusk and dawn
(night), when the mosquitoes that transmit malaria are most active
 Most commonly used active ingredient in insect repellents
 Not using protective measures (e.g. mosquito repellent)
 Most effective protection against mosquito bites
 Age
 The higher the concentration, the longer it is effective for
 History of exposure to malaria - No added protection at concentration over 50%
 Pregnancy
 Blood transfusions or organ transplants (rare)  Generally safe; rarely causes skin rashes
 Do not spray directly on face
- Spray onto hands, then rub onto face
- Avoid the eye and mouth areas

 Can be applied onto clothing and other protective covers

 L05: MALARIA PROPHYLAXIS
TREATMENT OF MALARIA:

MEDICATION (Anti-malarial) REQUIRE Rx? HOW IS IT TAKEN?

The medication is taken once weekly.
Chloroquine
NO (P) - Start one week before departure
( × Breastfeeding)
- and continue until 4 weeks after returning.
The medication is taken once weekly, on the same day every week.
- It is usually started 2-3 weeks before departure
Mefloquine NO (P)
- and continued when in the endemic area
- and until 4 weeks after returning.
The medication is taken once daily.
Atovaquone – proguanil
NO (POM w/ exemption) - Start 1-2 days before departure
( × Pregnancy, Breastfeeding)
- and continue until 1 week after returning
The medication is taken once daily.
Doxycycline
YES (POM) - Start 1-2 days before departure
( × Pregnancy, Breastfeeding)
- and continue until 4 weeks after returning.

L05: THREADWORM INFECTION

OCCURRENCE OF THREADWORM INFECTION: TREATMENT OF THREADWORM INFECTION:

 Spread via faecal-oral route

 Benzimidazoles
 Occurs via contact with contaminated
- Albendazole
- furniture
- Mebendazole
- bedding
- towels
MOA OF DRUGS:
- toilets
- doorknobs
 Selectively bind with high affinity to the threadworm β-tubulin
 Inhibit microtubule polymerization, resulting in the destruction of
SIGNS & SYMPTOMS OF THREADWORM INFECTION: cell structure and consequent death of the threadworm

 Itching of the anal or vaginal area (may be intense)

- Leads to sleeping difficulties and restlessness
 Prickling sensation in perianal area (at night time or early morning)
 Rare: abdominal discomfort and loss of appetite
 Some may be asymptomatic or are only mildly affected
NON-PHARMACOLOGICAL METHODS TO PREVENT RE-INFECTION:
 Practise proper handwashing techniques
- Before eating
- After using the toilet or changing a diaper of an affected baby

RISK FACTORS:  Laundry should be cleaned thoroughly and regularly

- Regular laundry soap can eliminate pinworm eggs
 Children < 18 years old - All affected bedding and toys should be cleaned
 People who take care of infected children every 3-7 days for 3 weeks;
 Institutionalised persons (refers to those who are staying in nursing - Underwear and pyjamas should be washed daily for 2 weeks
homes or long term care hospitals. - Shower in the morning daily to remove pinworm eggs that may
have been deposited overnight.