madaboutcheetah

Anti-Malaria medication? For the Okavango and beyond!!!

48 posts in this topic

Hi! I often read millions of threads all the time on F regarding anti-Malaria medications ......... What is the practice of the readers of this forum? Many of us travel regularly to the Okavango and other Southern African safari areas, some of you live in Africa and go on many safaris every year. So, what do you do?

 

I'll start - I don't take any pills on safari. I have travelled all different times of the year (dry and wet months)........ Yet, I must say I don't spend much time in towns or cities like Maun or Kasane where there are possibly more people (my presumption is, the malaria parasite is transmitted more from a mosquito biting a malaria patient and then biting you).

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I took my last pills three years ago when visiting Bangweulu (I didn't trust the combination of swamp plus people). Had a nice discussion with a lodge manageress in Kafue earlier during that trip who called me an idiot because of taking these drugs.

 

I certainly won't take any pills if going to the Delta. Ridiculous, unless you spend some time in Maun or other urban areas.

 

I always carry some pills as stand-by medication, just in case, but so far never needed them.

 

And I'm a big fan of good old L. I love the first 24 hours when taking them. And my colleagues love it, too, because I'm rarely so relaxed than on this day. :rolleyes:

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SLIGHTLY OFF TOPIC

 

"In 1999, the 15% of the world’s population who live in high-income countries purchased and consumed about 90% of total medicines, by value. This concentration in the pattern of global sales and consumption has increased over the past 15 years, with the share of the low-income countries falling and that of the high-income countries growing. The market share of the USA alone rose from 18.4% of the world total in 1976 to over 52% in 2000."

 

from WHO's The World Medicines Situation - Chapter 4. World pharmaceutical sales and consumption

 

Very simplified this says that some 300 Millions US citizens are consuming more than the half of the world's medicines. In some way this explains why those medical discussions on F sometimes look a little bit "hysterical" to non-Americans.

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I always take Malarone. I agree that there is less chance of contracting malaria in Botswana, but, camp staff go on

 

leave into populated areas and could return with malaria. The mosquito bites staff member, and then bites you--

 

bingo! My late husband had malaria twice. once after returning from Mozambique, and then returning from Zambia.

 

After the Mozambique trip he was taken into a London hospital and I was told that there was a very good chance that

 

he would not make it. Fortunately, he did. Therefore I always make sure that I take my Malarone for the required

 

time.

 

 

Jan

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I'm with Jan on this one. Malarone suits me (1 day before to 5 after is my limit). I've seen Malaria at work and have no wish for even the mildest attack.

Being out in the Bush isn't protection from Human "carriers" as there are villages near many of the "wilderness" areas - take Lagoon as an example; miles away from a Botswanan vilage (if you ignore the BDF camp) but not that far from Namibian Villages.

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Malarone suits me (1 day before to 5 after is my limit).
Even if I want it I couldn't take it. All my last safaris were 4 weeks long, and M has a maximal allowed prescription time of 28 days in my country (and I think, this is true for the rest of Europe as well).

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28 days is the recommendation in the UK as well. For my 4 weekers. I cut out Joburg airport (over 2,000 metres) and any other days I can and cross my fingers :rolleyes: Even then I've over run by a week and not noticed any ill effects (someone who knows me will probably post otherwise). Is the time limit to do with the Kidneys or Low blood pressure or something else?

 

Was it the case a few years back that most German doctors stopped advising the taking of anti-malarials?

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Was it the case a few years back that most German doctors stopped advising the taking of anti-malarials?
I never heard of this, and based on talks with other German travellers and what I read on German travel forums I can't confirm this.

 

My decision has grown over years, is based on travel experiences in those areas, on talks with people working in that areas, talks with experts in our local tropical disease centre, WHO recommendations and books/papers about the issue.

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I take Lariam (in East Africa), but would like to save the money. Now I have 3 pills with a March 2009 expiry date which I think will still be good and a couple of pills with a February 2006 expiry data which feel a bit old. The mosquitoes love me and more than once have I heard of camp staff that are in bed with malaria. And, I’m going to areas with a lot of people. Can I skip the pills? I don’t care if you are doctors or not.

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I take Lariam (in East Africa), but would like to save the money.
I don't take these pills because I want to save money. I don't take this medicine because it's a drug and bad for my health. I'm making a risk assessment, choosing between a controlled poisoning which gives me some protection or the likelihood of being bitten by an infected mosquito and catching the disease. Anyway, I'm always carrying these pills as stand-by medication (as recommended by WHO for these areas).

 

 

Can I skip the pills?
I guess you already answered this:
The mosquitoes love me

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Another reason for camps to consider lanterns, soft lighting as choices - fewer mosquitoes. I find every bug and insect, not to forget mosquitoes attracted to the harsh modern lighting....... a definite NO NO for the Linyanti!!!! - atleast for the common areas (lounge, dining etc etc)

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Nyama,

 

If you are carrying these pills with you as stand-by option, how do you later determine that you need to be taking them? How do you make the assessment?

 

In my very first trip to Kenya - I took some anti-malarials with me. Had a really bad stomach reaction and quit after only two or three days. Could not handle it. Didn't ever consider taking them again.

 

Btw, I also live in India - and although not a high risk malaria zone - we have far far more mosquitoes out here than anywhere in Africa.

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If you are carrying these pills with you as stand-by option, how do you later determine that you need to be taking them?
Malaria symptoms are clearly described. If you show such symptoms in a remote area and no doctor is available, you can use these pills for a first emergency treatment.

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And I'm a big fan of good old L. I love the first 24 hours when taking them. And my colleagues love it, too, because I'm rarely so relaxed than on this day. :rolleyes:

I feel cheated. I never got a Larium buzz.

 

I do what my travel doctor advises, which is take a malarial prophylactic. The last few trips that has been Malarone. I do think there is a lot more prescribing going on in the US compared to other places. Every third advertisement on TV pushes a drug for something.

 

The latest says, "Men, if you are over 45 and are tired and don't have the energy you once had, maybe you have Low T and should buy this drug." Low T is for low testosterone. Well, who isn't a little more tired and less energetic after 45 vs. 25? Maybe I have Low T too because I no longer dance the night away. Ridiculous.

 

My grandfather used to have a saying for some family members who medicated heavily. He said, "They have a pill for when a fart comes out sideways." That comment now applies to a huge segment of our population.

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I always take Malarone and have never had a bad reaction. I follow the medical advice because I saw school friends from Africa with malaria as a child. Also malaria deaths and/or cases in people returning from Africa are regularly reported. Some of these are in people on package tours to places like the Gambia, who didn't know there was a risk and I wouldn't want to appear as ignorant as them!

There was an interesting article in the Times last Saturday about a women who contracted malaria whilst taking malarone. The consultant said this was very unusual.

http://www.timesonline.co.uk/tol/life_and_...icle6292951.ece

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Maybe I’ll continue taking Lariam then. I’d prefer not to.

 

Btw, in "all" books it says you should seek inmediate medical atttention if you have a fever in connection with an Africa trip. I came home with a high fever in 2005 and went to a doctor even though I usually avoid this, but I was never tested for malaria.

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It baffles me why anyone would take the chance of getting malaria. I've managed to get the damn parasite, and wish never to have it catch me again.

 

And this thinking of going into the bush away from other humans where you won't get bit by a mosquito carrying the parasite is even more C#@&. You can bet that the camp staff often pitch up while sick. I've seen it in many camps.

 

Taking the 'cure' after you get malaria is like closing the barn door after the cows got out. It can still be too late. Once you have it, there goes the rest of the safari. Sure, coartem is effective and non-toxic, but it takes a few days and several cycles to kill the parasites, if you are lucky. Then the recovery can take over a month, assuming you do recover.

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It baffles me why anyone would take the chance of getting malaria. I've managed to get the damn parasite, and wish never to have it catch me again.
What baffles me is how many people blindly swallow all kind of pharmaceuticals without questioning it. I made some bad experiences in this regard in my family and thus my life's premise is avoiding diseases AND taking as few pharmaceuticals as possible, especially those whose package insert reads like a Stephen King novel.

 

Travel doctors are like TAs. If you're lucky you meet one who at least has visited the destination country and has some first-hand experience, but most of them just ruminate the general guidelines published by the country's disease centres or international health organisations. At the tropical disease centre in my home town we have travel doctors from Africa, even from the same countries where I go on safari, but even those guys told me in confidence that their recommendations are just based on general worst case scenarios but don't say anything about remote safari destinations because they don't have knowledge about the situation in those areas. Isn't it funny how many travellers are very selective with their TAs but blindly trust any travel doctor's advice?

 

I began questioning all this after my first three trips to East Africa during dry season and hadn't got any insect bite at all. Of course I'd been told that it's a dangerous malaria area and, well-behaved as I was, had swallowed those power pills. Not a single bite - and I even hadn't used any insect repellent. After that I decided to dig a little bit deeper into those small discrepancies between travel health advices and real-world experiences...

 

 

luangwablondes, I assume that you didn't get your parasite during a fly-in safari to remote areas, did you? My personal risk assessment has certainly a different outcome if I choose to go on a self-drive trip and stay several days in highly populated areas and not just a few hours on an international airport during daytime.

 

Malaria-infected staff members in a remote safari camp? Sure, there's always a rest risk. We also have plane crashes from time to time.

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Proof of the reasons for the above is provided by the latest nonsense on F
You should re-read that thread. We have some great divine advice there... :lol:

 

 

I'm just thinking about buying some shares of certain pharmaceutical manufacturers and then posting in F's Europe forum about the dangers of tickborne encephalitis...

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Nyama

 

Do I really have to reread F , I would prefer not too.

 

 

The main reason I do not take Malaria prophylactics is the time I spend in so called dangerous areas, long term usage is very bad for you.

 

I have also been told that the constant use by so many people will mean that eventually these "medicines" will loose their effectiveness, and their (Larium) use in the treatment of people who have actually caught Malaria will be useless.

 

Anybody know when the Chinese stuff will be available?

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One of the biggest culture shocks when visiting the F is the enthusiastic munching of antibiotics. All Fodorites have one called Cipro on the packing list. Everyone I know – in Sweden, Spain is a different case - only use antibiotics when it’s absolutely necessary and never for viral infections. On the F some posters even recommend preventive usage of antibiotics. The only reason I can think of for something so insane is lots of shares in pharmaceuticals companies. Though I don’t really know that much about health issues and I never get around to contacting antibiotics awareness groups to ask what I should post on those threads.

I'm just thinking about buying some shares of certain pharmaceutical manufacturers and then posting in F's Europe forum about the dangers of tickborne encephalitis...

TBE shots are already big business this time of the year.

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I'm late to this thread.

 

I too have witnessed first hand the effects of malaria. On a walking safari in the early 1990's I literally walked/carried the tracker back to camp. I have never seen anyones skin turn so grey and his shuddering was horrendous. Luckily the necessary medication was back at camp.

 

From that day on I knew I could not afford to get that disease and have taken precautions ever since.

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Always take my pills, but when possible I buy Malazone, in Zimbabwe - when the exchange rate worked in our favour it was US$1 for 6 months' worth. They were probably out-of-date generics, but made us feel like we were doing the right thing.

 

I bought a tester kit in SA on the last trip and reckon that's a good thing to carry, plus some black market coartem we got off a hunter.

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All Fodorites have one called Cipro on the packing list.
You wouldn't get a prescription for Cipro at my place just for the travel health kit.

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