I'm planning to spend 8-12 months in Africa, and all the
countries I want to visit have high malaria risk. What have
you African travellers done about this problem? Taking the
anti-malaria pills (I have Lariam) for too long is
dangerous, and not taking them regularly is
dangerous...should I just take them in extremely risky
places?
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I have been to Africa three times.
I am leaving for Kenya in two weeks from now.
You better take the malaria pills. I know travelers who
died of malaria because they had the same concerns as your
and they refused to take their pills. Apparently they got
hit by the disease.
Good Luck
http://www.backpackafrica.com/malaria_info.html
is probably what you should be reading....
Before I'd read these pages, I'd never heard of side
effects from the pills...possibly someone can quote from
the packaging? (I've never experienced any, except on one
occasion when I took too many!)
I was in Africa for 8 weeks and took Lariam the whole time,
it didn't affect me at all. But some people in our group
complained of not sleeping, palpitations etc.
Basically if they don't affect you I would definitely take
them, so its worth trying them for a couple of weeks and
seeing if you have any side effects.
You have to remember that they can take up to four weeks to
kill the malaria, so you can't just take Lariam in high-risk
countries and something else as soon as you move out of the
high-risk area.
The best advice is just to not get bitten! Get a really good
net (& a sewing kit to fix any tears in it) and some really
nasty strong deet repellent.
Good luck!
i was told to take larium not longer than 3 months orso, and
then switch to anoter one, there is one to take everyday,
unfortunately i forgot the name
have fun pieter
On my trip, I was away for a year, leaving Morocco in Oct
and arriving RSA in the following Sept. We didn't take the
tablets until Mauritania, giving a week or so to build up
resistance before meeting the first mossies in Mali
(Bamako), we then took the tablets from then (Nov) until
arriving in Uganda (March). In East Africa we had a break
as the combination of dry season and altitude, reduced the
number of mossies (hardly saw any). We took then again for
Lake Malawi (week before, followed by four weeks after) and
then stopped through Zim, Bots, Nam and RSA.
This was a concious balance between the long term risk of
chloroquine/paludrine and malaria. Basically we tried to
follow the local ex-pats in each area. If you are
travelling in the wet season, then the risk of malaria is
much higher, so take the tablets. Our route folowed the dry
season, partly for malaria risk, but also the climate is
more comfortable.
Finally, as always, you only get malaria if you get bitten,
so protection is best. Cover up when the sun goes down, and
use a repellant.
I just picked up my Larium pills and it states that it
should be taken once a week. i though it was everday. Is
this correct?
Ohhhh no, every week is right. Take 'em every day and they
mess with your head, man.
Sirena
I've worked in a high-risk malarial area (Zambia) for a
couple of years, and in my experience it is not wise to take
anti-malarials for extended periods of time.
I wasn't on Larium but dyoxy though essentially they both
damage your liver. I ended up stopping during the dry season
- not that it helped, cause I ended up getting it anyhow...
I took Larium for a year when I was in Kenya, on the advise
of my doctor. Most doctors are clueless when it comes to
malaria or tropical diseases. They open a book and say,
"hmmm...well, it says that you can get malaria in this
country so you'd better take the medication." I had a
discussion with a doctor in Kenya after about six months
there (and a dislocated shoulder in a car accident), and he
nearly passed out when I told him I was told to take the
medication for the year I was there. It was my first time
abroad, and I was young and naive, and probably should have
done more homework on this issue. I didn't notice anything
really bad there but my hair would fall out (faster than it
usully does!!;>)). I did have a grand mal seizure a year
later, and I was always curious as to whether the
medication I took had anything to do with it. They did all
these tests and didn't find anything. I haven't had one
since and I feel fine today. I'm thinking of returning to
Africa next year and I'm a bit concerned about what to do.
Any advice on countries I could go to where malaria is not
a big problem? I'd prefer not to take the damn pills.
Sirena, you should take this issue up with a doctor who has
more insight into malaria and these kinds of illnesses,
diseases, etc. Good luck.
I agree with Tramper and Rob. If you can, speak to a
tropical disease specialist about the long-term effects of
anti-malarials; talk to travellers; talk to the expats who
are living in the countries you're visiting; and even look
through a pharmaceutical book to check on the drugs and
their side-effects. However, the pros and cons of which
anti-malarials to take or in fact whether to take one at
all, is a never-ending topic of conversation and there
seems to be no definite concensus except to make your own
educated decision based on your own experiences and the
malarial conditions in the country you're visiting. As an
expat in Nigeria (4 yrs) and Uganda (3 years) and after
many visits to East Africa there seem to be two issues:
whether or not to take any anti-malarials in the first
place (or just use better protection measures and then have
blood samples taken at the first sign of illness); and the
second issue is, if you decide to take anti-malarials then
which one for a long-term stint? Larium is not recommended
for long-term use as far as I know - however it is the drug
of choice for short-term by most doctors I have dealt
with. Usually for long-term a combination of drugs is
recommended, such as Chloroquine (weekly) and Paludrine
(daily), but there can still be side-effects as with any
medication taken. If you only take anti-malarials in the
'risky' areas you may not be covered as malaria can take
several weeks to develop, which is why it's recommended to
take anti-malarials for one month after returning from a
malarial zone. It's not an easy call to make and once
you're in Africa you may decide to switch, which is what
many expats seem to do. I took Larium for a couple of
months, switched to Chloroquine and Paludrine, then stopped
completely for the last year and I was malaria-free.
However, during a 2 month stay last year with no anti-
malarials, I did have malaria but very mild as it was
caught early on. Whatever you decide I hope all goes well
for you and that you have a great time.
The US Peace Corps issue mefloquine as standard procedure.
I took em for 2 years--no side effects, no malaria. A few
in my group stopped; some complained of nightmares--I'm not
convinced it's solely due to the drug, considering you're
exposed to an entirely strange new environment all of a
sudden.
Speak to any peace corp volunteer... most were on malaria
meds for two years.... they should help your peace of mind
or confirm your fears... good luck
We know some PCV's. They were surprised to find that it
should not be taken for more than three months. This is the
manufacturers reccomendation.
We have seen many people with bad side effects. Ben was
almost hospitalised in Eritrea with the side effects.
Seriously.
The side effects can be lessened by taking half a tablet
twice a week.
Hi Sirena,'
Lsten to tramper,
Staying different parts of Africa for longer periods
I recommend
to be aware of mosquitoes and
to protect ourself especially in the evening wear long
clothes and staying behind mosquitonets after one hour
before sunset (6 p.m.)
Profylaxis is no guarantee against malaria but will make
detection (laboratory) more difficult when taken.
Therefore use mosquit spells on nude areas on the body in
the eveninbg !
Regards
Go to someone who knows. Larium given to the wrong person
can be disasterous. There are ten questions about yourself
which need to be answered (are you paranoid, depressive,
etc) to judge if you should take it. It should not be taken
more than 3 months anyway. It can be used as a cure (ie
after infection) - ask an expert for detials. Concentrate
more on prevention of bites than anything.
If you do get malaria, the most important thing is to keep
your temperature down (ice, water, anything). Do not hold
back because 99% of the time it is the high temperature
that cooks your brain and kills.
Don't be paranoid about getting malaria, be paranoid about
not getting bitten.
Have fun
but don't you love those bizarre dreams when you take
larium ?
I kinda miss my weekly visits from the 'larium girls' now
that I'm back home...
Malaria kills. I found myself in a hospital after being
unconscious for 3 days. I also have taken Chloroquinine for
years, and Larium for weeks at a time. Do your own
research. Expect conflicting opinions from "professionals"
and lots of anectdotal stories from travelers.
~
Be aware of the need, types of misquitoes, the risks,
prevention, the treatments, and the symptoms of both
malaria and various "side-effects." Remember, when
traveling many places, you gotta haul your own ass out. You
must be as aware as possible, and then symply use your own
best judgment, based on the best information.
~
Try CDC and IAMAT for some excellent information. They are
on the net. Search: "Malaria" etc.
~
You can take every precaution under the sun and the hallowed
advice of every tropical disease specialist and travel-weary
person out there. But if that anopheles mossie gets you and
the fever starts to kick in, and you happen to be a few
thousand miles from the nearest decent medical facility, you
better have a self-test kit and treatment dose of drugs
handy. There are many options, ask your specialist about
them.
I agree with everyone that if you are going to a high
malarial region, it is important to use caution and take
some sort of prophylaxis. Howevere, in my own experiences..
Went to kenya for three weeks, took larium, no problem. Two
years later, went back for 6 months, took larium...
Major problems... The typical nightmares (which are so vivid
and distressing I don't think they can be called typical - I
actually thought I had shot my mother in the head at one
point and it took a friend to calm me down and tell me it
was a dream, even though my mom was in DC, Not anywhere near
Nairobi!), weird mental experinces during the day, a
decreased torerance for stress, many 'ugh' more...
The problems I was experiencing were so distressing and
lifestyle-inhibiting that I decided I'd rather get malaria
than continue on with Larium. I eventually took some other
more mild anti-malarial and was ok with that, But when asked
by anyone about Larium, I am adamently opposed to it.
Upon return to the states a mild form of the symptoms
continued, especially the dreams, and I am still affected 4
years later. There are many studies that have been done and
it is known that anyone with any history of psychological
problems (especially familial depression or schizo.) should
not take Larium.
Do research. Protect yourself from the disease and the
drug!!!
I read ALOT about Larium versus other meds as I'm going to
high risk areas for 3 months. Here's some snippets :
I spoke to ex-pats who'd lived in Zim for years and they
thought initally I was going too long to be on Larium. But
also took into account that I would be travelling in and out
if low and high velt as they called it, so perhaps it was
necessary. They had all taken a local drug called DeltaPrim
which might be worth checking out (aka Maloprim).
Larium is also used as a treatment and some east african
doctors do not like westerners on Larium as they fear that
the malaria will become resistent to it and they will have
one less treatment and alot more problems.
Larium is not widly known in west africa and Mefloquinine
intolerance (unable to take Larium because of severe side
effects) is often confused with Malaria.
From talking to people I have a theory that what you intend
to be doing/your state of mind and security affects your
reaction to Larium. People in stable environments like
voluntary workers tend to have mild side effects, whereas
many independant travellers on the move all the time and in
new surroundings feel edgy, paraniod and generally "not
themselves".
No widescale study of tourist populations taking larium has
been carried out. Most studies have been on male miltary
personnel. More vicious side effects have been reported in
'slight' people ie under 50kgs. There is only one available
dose of Larium regardless of build.
Alcohol has also been a factor in side effects, you are
recommended not to drink 24 hrs before and after your
weekely dose.
Dioxy is not a good idea for women as its an antibiotic and
so can cause yeast infections (ouch!) and it makes you
sun sensitive.
What I'm doing:
taking lariumm for a month before I go (4 tabs) and will
continue with it if I have no very bad effects. The no
drinking will be difficult for a irish person though!! ;-)
My advice:
Unless you drink very heavily, are a small person or have a
history of depression/mental illness try Larium first. Take
Choroquine and Pauldrine if larium doesn't work for you.
Think carefully about larium if you are travelling
independantly (I'm going with a tour group)
good luck!
Do not take lariam for longer than 2 months. The side effects are too bad and it hurts your liver. I would not take them at all but carry them around. As soon as you think you have malaria take the pills or go to a medical assitant who are all over. That┤s the way the South Africans do it as well