Malaria prophylaxis in India: should you take it or not?

Sooner or later we had to address the topic, and so... here we are answering one of the most debated questions: when traveling to India, is antimalarial prophylaxis worth it? We decided to dedicate an article to this topic because we know it is often a source of concern when planning this kind of trip.

However, we feel a premise is necessary: perhaps more than ever in recent years, discussing prophylaxis and vaccinations has become an extremely delicate matter. We therefore want to make it clear that the advice you will read in this article is not medical in nature, but purely conversational. We are not doctors. Imagine you are talking with a friend called "Sto Gran Tour," who has already been to India (more than once) and simply wants to offer free advice to anyone about to have this experience. Nothing more than that! After chatting with friends, however, you should in any case consult a doctor who is experienced in this field, and that is what we recommend to you as well.

What is malaria and how do you get it?

You may already know this, or maybe not. Malaria is an infectious disease common in tropical and subtropical countries that is transmitted to humans through mosquito bites.
It is caused by protozoan parasites of the genus Plasmodium, pathogens transmitted to humans through the bite of an infected mosquito of the genus Anopheles (the vector). These vector insects can become infected by biting a sick individual and then transmit the infection to a healthy person through a second bite.
 

Traveling to India: should you take antimalarial prophylaxis or not?

As of today, it must be emphasized that there is no total prevention for malaria: taking antimalarial prophylaxis helps reduce the risk of infection, but it does NOT provide 100% protection against getting malaria. Prophylaxis is NOT a vaccine but, precisely, a preventive treatment. 
Another factor not to underestimate is the effect of prophylaxis, which in some cases can be quite hard on the person taking it because of its strength and the effects it has on the body, especially on the liver. Deciding whether to take prophylaxis is a very personal choice, which also depends on your state of health and your tolerance to medications (also considering, as mentioned earlier, that antimalarial drugs often cause side effects). 

We have asked ourselves many times whether prophylaxis is necessary or not, and what to recommend to Sto Gran Tour travelers. 
Our opinion is that if you think the idea of malaria could in any way ruin your trip, putting you in a state of anxiety and stress throughout the experience, then we recommend taking it. It is not worth spending your days in discomfort if you can choose to take a medication that can effectively reduce the chances of infection and, at the same time, ease your psychological burden. 
We would also add, having followed the debate for years, that malaria treatment has made huge progress. There are very innovative drugs that are easy to obtain in India, based on a substance called artemisinin, generally used in combination with another antimalarial such as chloroquine or amodiaquine. One pack costs less than 10 euros. When taken at the onset of the first malaria symptoms, this medication eliminates the disease in 97–98% of cases without consequences. In addition, since 2021 there has been news of a possible vaccine, but as of today studies have not yet been completed. 

How can you protect yourself from mosquitoes in India?

When we at Sto Gran Tour travel in India, whether or not we decide to take antimalarial prophylaxis, we always take constant precautions to prevent mosquito bites. Here they are:

• Repellent spray and mosquito-repellent bracelets

Simple but effective: we use tropical mosquito repellent sprays, such as Autan Tropical Vapo Repellent or something similar, to be used day and night (because unlike malaria-carrying mosquitoes, dengue mosquitoes are active during the day as well).

• Liquid room mosquito repellent

When we arrive in the room, we plug in a mosquito repellent diffuser, the kind with liquid refills. There are several brands, such as Raid and Autan. 

• The legendary vitamin B

Before leaving, it can help to take vitamin B supplements, a vitamin complex that (along with many other beneficial factors) has the advantage of giving our skin an odor that mosquitoes dislike, so they avoid biting us. 

• Bed mosquito net

Hotels and B&Bs often provide them. But to avoid being completely unprepared, you can buy your own mosquito net before the trip. Once you arrive in your room, if you notice that the bed is not equipped with a mosquito net, you can hang your own over it. A bed mosquito net is a kind of canopy that, when draped over the bed, covers it completely and keeps mosquitoes away during the night.

• Biokill

Be careful! It is not a repellent to use on the body. Biokill should be used exclusively on mosquito nets, clothing, and beds: it is an insecticide spray based on permethrin, effective against cold-blooded insects. In addition to keeping mosquitoes away, it is also effective against mites, fleas, ants, and cockroaches. You can also buy the eco-friendly version of Biokill!

In this article we have looked at what malaria is and its effects, and how it can be prevented by choosing whether or not to take antimalarial prophylaxis. We hope you found it useful!
In any case, talking about necessary vaccines for India and antimalarial prophylaxis is not the whole story. There are still a couple of useful tips about the precautions to take when traveling in India, and we talk about them in this article.