Hi all,
I'm heading to Africa, and hence need to nail down what to
do re. malaria. This is what I (think I) know:
1) Mefloquine (Lariam) once a week prophylaxis
OR
2) Chloroquine weekly + Proguanil daily phophylaxis
Ok, now, I've also heard that i need to carry a cure with me
in addition to the prophylaxis in case i get malaria in
spite of my efforts. So, what constitues a cure? Say I'm
on Lariam, and get malaria. Do I then use Chloroquine and
Proguanil as the cure? Do I stop the Lariam at this point?
I have spoken with Doctors already about some of this, but
wanted all the information I can possibly get. Don't I also
need a self-diagnosing kit? Are these reliable?
oh, one more thing. What mosquito netting do people use?
One that drops over your bed/sleeping bag? Or just the
helmet type? Or not at all?
Thanks all in advance.
allie
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If you get malaria than you will need to get to a hospital
and they will most likely give you some antibiotics to get
rid of it. If this happens you will be off of your feet
for a while. If you feel ill for more than a few days than
it may be a good idea to get checked out. In some African
countries you can buy a drug called Fansidar. It is not a
cure, but will hold you over for a few days until you can
reach a hospital. This is a very strong drug and side
effect should be expected. I would not worry too much a
malaria as long as you are taking precautionary measures.
1) Doxycycline (100mg daily) is another prophylactic option;
2) Treatment drugs depend upon your choice of prophylaxis.
Larium treatment dose will NOT work if you have been on
Larium as pro' but it will if you are on any of the other
drugs. Malarone and Fansidar seem to be the recommended
treatment drugs for Larium poppers. But you only need a
self-test kit and treatment dose if you are heading away
from the big cities and their hospitals.
3) Best choice of mossie net depends on what you're doing. A
bed style version (with a SINGLE suspension point or self
supporting structure) is good if you're hostelling /
hotelling. I've only used my helmet style one Twice. But if
you're spending loads of time on beaches or in wetlands, it
will probably come in handy. If it hasn't been already,
treat it (and an old long sleeve t-shirt for night walks or
sunset spotting) with pyrethum.
4) Talk to a tropical disease specialist / travel clinic
before departure. They usually know much more than us
amatuer Thorn Tree medics.
mixing drugs can be very dangerous - check they don't react
with each other! Ask the medic specifically.
I don't know how many times I've contracted Malaria. I'd say
a bit more than 15 times to say the least. If you're
planning on going to a French speaking country in Africa
then I'd recommand that you regularly take some Nivaquine.
It usually does the trick before and after contracting
Malaria.
My advice is to take a net that fits over your bed. I
always carry one that fits a double bed as you never know
what you will get in various hotels. Make sure it is
treated with pyrethrum. I have been told by doctors that if
you treat it and don't actually sleep under it (say you
just leave it hanging nearby) it will still keep the
mosquitoes away due to its repellant properties.
I think however you will find that to have a good nights
sleep you will want to sleep under it. In some places the
air is thick with mosquitoes at night and sleep is
impossible with all the buzzing and biting - malaria or no
malaria.
As for treatment of malaria - don't mess around. Take the
advice of your doctor, not fellow travellers. Local doctors
(just about anywhere in Africa) are as good, if not better,
than anyone in treating malaria - they see thousands of
cases. Mind you thousands of people die from it too but
generally that is because people seek treatment too late
and then don't have access to the necessary drugs to treat
it.
about mosquito-net.. last time i vent to africa i brougth a
"tent type" net. It is a little expensive (99 dollars) and
a little heavier than the traditional nets, but for me it
was wort it all. You don't have to worry about where to
hang it, once you are inside and the door is closed, you
are safe. Check out http://www.travelmed.com
The most important thing is to take the drugs you feel well
with, physically but also mentally! There have been many
reports about side effects through Lariam. I usually take
Chloroquine (Resochin or Nivaquine) plus Proguanil
(Paludrine) as you suggested, and carry Lariam with me as a
"cure prophylaxis". Make sure to carry on with your
prophylaxis for 4 more weeks after you have left the
malaria area (many people stop taking malaria drugs
right after getting back home, and this may be fatal!). Do
NOT use Fansidar! Also, Doxycycline is NOT a proper malaria
treatment! The best protection in any case is a mosquito net
covering the whole bed/body, long shirts/trousers during
evening hours, and insect repellents.