menikos,
If you’re from Paris, I’m sure you’ll be able to find the French national institute of tropical studies, whatever its precise name may be. Ask them for their medical department or (if it still exists) the specialized tropical diseases hospital. Then tell those experts precisely where you’re going, what you’ll be doing and for how long, and they will give you the most current and up-to-date recommendations. I cannot emphasize the importance of the latest info enough: the parasites constantly evolve and misuse of malaria drugs (mostly: not taking the complete course) leads to drug-resistant strains developing in an amazingly short time. The info which was completely correct for one of the posters here even 6 months ago may be worse than useless to you now.
Malaria is a killer. Some strains can kill you within a day of the first symptoms showing.
In general, as with most bad things, prevention is better than cure. Firstly, avoid getting bitten. Sleep under a mosquito net, avoid going out at or after dusk, wear long sleeves and trousers at and after dusk, use mosquito repellant (and yes, the garlic eating helps).
Secondly, your body will to some extent fight the intrusion by the parasites by itself. Help your body by remaining healthy: regular light exercise (fitness freaks tend to be more susceptible to infections than normally healthy people), a balanced diet, avoid chronic alcohol abuse - that’s the hard one!
Drugs that can be taken as prophylactics (prevention), have many drawbacks. Their efficacy is most limited against falciparum malaria – the most dangerous form. Some have side effects that preclude flying while you’re taking them, others have side effects after long-term use. Once again, discuss with the experts in tropical medicine – not with pilots – whether or not prophylaxis will be right for you. Do mention you’re a pilot though, it will be an important factor in their recommendation.
Lastly, realize that none of these defenses are perfect. If you start feeling woozy, take your temperature. If you are running a fever, get a blood test done – NOW! Forget the idea of self-test kits, a blood test for malaria involves taking one drop of blood, concentrating it in a centrifuge, and looking at it through a microscope to identify the parasites. Takes about 10 minutes, but it requires equipment found only in a doctor’s office. If you cannot get a blood test done right away (within one hour), start taking the prescribed drugs for a malaria attack, and still get the blood test done as soon as possible. If the blood test turns out to be negative for malaria, no harm will have been done by taking the drugs. To follow this last advice you should carry a complete course of malaria treatment with you.
As an aside, I’ve noticed some people take such pride in their relative immunity to malaria that they go into denial about having the disease and refuse treatment or even testing. Sound crazy? It is! They all wound up in intensive care and one guy’s kidneys had started breaking down by the time we got him on an ambulance Lear to Geneva.
After returning to Europe, don’t think you are out of the woods yet. People have gone down with malaria 6 months after leaving Africa. Actually, a very few have contracted it years after their departure but their numbers are small enough to ignore. I would advice to always carry a card stating you have just returned from a malaria area and that if you collapse, a check for malaria should be run. One problem people returning to Europe or North America have encountered is a reluctance bordering on obstinacy on the part of some doctors to consider the possibility of malaria; they see it so seldom that they aren’t familiar with tests or current drug regimes and seem to have a hard time acknowledging the fact. I would suggest instructing your family and/or co-workers that if you have a bad fever and are unable to fend for yourself they should ask the doctor if he tested you for malaria, and if the answer is along the lines of “Oh, it’s a flu, no need for that” to take you, by kidnapping if necessary, to a hospital specializing in tropical diseases. I personally know three people who are alive today only because their colleagues kidnapped them from a hospital and took them to a Navy clinic.