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Staying Healthy on the Road Medical info, e.g. malaria, vaccinations, travel medical tips, medical insurance, where to find a doctor.
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  #1  
Old 13 Jul 2011
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Malaria drugs, yes or no?

Who has experience with or an opinion about the malaria drug Lariam? It is a drug that can be used against malaria when you’re visiting a malaria-area longer than a few weeks, in contradiction to Malarone, which is used for short visits to malaria areas, or can be used as an emergency medication, so we’ve been told.

We are a couple now travelling on our Honda Africa Twins in Mexico, and are travelling south. Soon we have to decide wether or not to take malaria medication preventively.

At first, we decided just to take the Malarone with us to use only in case of emergency, so when we get malaria and can’t go to a hospital fast enough, and not take any other medications for the following reasons:
- Lariam is known for possible side effects like hallucinations, depressions, etc. (although just a few percent of people is suffering from these side effects, it doesn’t sound like a nice drug to us…)
- Malaria drug can prevent malaria, but it is not guaranteed, so you have to be careful anyway
- Malaria is more difficult to detect in a hospital once you’re using a malaria drug

But, now we are in doubt whether or not to use Lariam as a preventive drug, because at the moment we find it almost impossible to prevent mosquitoes from stinging us, so how can we prevent getting malaria later on when we are in malaria area’s?

If you have experience with this subject, please let us know your opinion and experience. Thanks for your advice!

Greetz, Daan and Mirjam (www.farawayfromflakkee.nl)
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  #2  
Old 13 Jul 2011
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I took Lariam on a visit to south India back in 1999.
I didn't have any side-effects other than sometimes a bit of a stomachache right after taking the pill. On the other hand I've heard of some folks having quite wicked side-effects.

Personally, I would take other steps to avoid all mosquitoes, as they carry a variety of diseases. I think south of Mexico you are much more likely to catch dengue fever than malaria, and there is no vaccine or treatment for that.
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Old 14 Jul 2011
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I think it's worth taking a preventative - none is completely effective, but every little helps - as you say it's impossible to prevent all bites.

On our trip through Africa, we used Doxycycline as a preventative, very cheap and none of the harsh side effects that some people suffer with Larium. The one side effect it does have is that you mustn't take it on an empty stomach, or you will probably throw up - it happened to us when we'd not had enough breakfast before taking our daily tablet... Another advantage of Doxy is that it's an antibiotic, which can help against stomach upsets at the same time (not that taking antibiotics long term is ideal in any way, just nicer than getting malaria...).

Lots of different options, but for long term use, I felt that Doxy was the best way forward for us. And we're both still alive...
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Old 14 Jul 2011
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I took Larium on my trans Africa trip 11 years ago. No side effects other than great (IMHO) sexual fantasies in my dreams on the night I took my weekly tablet (every Tuesday, if I recall correctly) Sadly, no dreams on any other nights

Didn't get malaria either.

HTH
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Old 14 Jul 2011
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malaria

I took larium for an pretty long trip in amazone and didn't have any side effect but few year later I did get malaria after a short trip in Guayana , I will always recommande to take what ever the local doc are recomanding and wear long sleeve at night.
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Old 14 Jul 2011
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I took doxycycline in Africa, and I've taken larium in SE Asia. I followed the instructions and haven't had any bad side effects from either.

I'm not keen on taking medication long term but I'm one of those people who the mosquitos love, so chose to take the pills. If you're lucky and don't get bitten so much, then maybe going with some testing kits and treatment doses of medication is better for you.

If you decide to take the pills make sure you choose one that covers you for the region you're travelling to. Not all pills will cover you everywhere.

For some further reading there's lots of good info on the Centres for Disease Control and Prevention website:

CDC - Malaria
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Old 14 Jul 2011
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Doxycycline

iv taken doxy for a six week period for the last five years while all over africa.i find it good, its easy to take and all it does is increase your emune system activity, theres no side effects and in my opinion is an easy if not perfect solution
damien
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Old 22 Jul 2011
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Malaria pills Vs malaria

Hi folks,

Its the age old debate..... Here is our contribution to the debate:
  • Malaria can kill you
  • Malaria can make a serious impact on your trip if you get it
  • It a risk that can be minimised and managed
We spent 9 months traveling in Africa, (north, west, central & southern) to some pretty remote places and found a variety of people who had some pretty strange ideas about malaria and malaria pills / treatments. We met one traveler who had it 5 times and he looked very "ill" but said he was not taking the tablets.....need we say more. I am not sure why people have such an "anti-malaria pill" attitude but the pre-treatments can and do help minimise your chances of developing the disease or assist the treatment should it be required if you develop Malaria during your trip.

The approach to Malaria has to be a combined approach and so the tablets are only one aspect. You can buy small test kits and most African clinics / doctors know exactly how to treat you. Time of year also has an impact on the mosquito populations for a given area / weather season you happen to be in. Data on this is available on the web. Covering up and using sprays also helps BUT you WILL get bitten on your trip.

We took Doxycyclin for 8 months (daily) and apart from some initial constipation and sun sensitivity we were fine. We had Malerone as a treatment should we develop Malaria and a few test kits that work on a pin-***** blood test. Some travellers thought we were mad for taking them for this period of time - they also happened to be the people who said they were not taking anything. If you are living long term in Africa I could imagine your approach might change but only if you know the local area, the type of Malaria that is prevalent and when the peak season is. For people passing through, I think its better to be taking something rather than nothing.

Since finishing the trip, we have stopped taking the pills after the defined period and have had no problems.

HTH

Nick
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Old 22 Jul 2011
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I took malarone for 6 weeks in West Africa without any side effects. My friend, who didn't take any pills, got malaria (in it's worst form). Took him weeks to recover and he had to be repatriated home. The Swiss owner of the zebrabar in Senegal contracted malaria 7 times in the 14 years he lived in Africa, it's a real risk. Take the pills!
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Old 23 Jul 2011
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You can take Malarone for as long as you want....or at least, for as long as you can afford it. The previous recommendation to limit use to one month has long since been superceded, although one government site in particular has failed, thus far, to get a clue.

Based on unfortunate personal experience, I strongly recommend against getting malaria, however you choose to accomplish this. I also recommend against putting too much faith in alarmist internet babble.

Hope that helps.

Mark
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Old 23 Jul 2011
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I wouldn't go for doxy if on a bike purely because of the space a daily tablet takes up. You could get them all in one pot rather than blister packs but then tablets don't last long being shaken about together?

I think I would fork out for Malerone, but I would most definitely take something, plus sleep in a net, plus have lots of repellant!

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Old 6 Aug 2011
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Larium does have a bit of a bad reputation for side effects with some people and it seems to be a bit of a lottery as to who gets what from it. I must admit to some anxiety the very first time I took it but like others, all I got was one night of weird dreams. Subsequent tablets had no side effects at all. Last trip I used Malarone and the main side effect from that was shock when I saw the price.

Whatever you decide don't let it be "we'll take a chance". I've seen quite a few locals in West Africa with malaria and it's a nasty disease. You will get bitten no matter what precautions you take and I'd rather take my chances with the drugs rather than the bugs.
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Old 6 Aug 2011
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malaria

I took Lariam for 1 whole year in Africa, no problems or side effects whatsoever. Lariam is probably the best and most proven prophylaxe there is but if you get the notorious side effects, then you got to switch to other stuff. Only few people get serious side effects and the side effects of malarone can be even worse! But even fewer people get those from malarone. It is very dangerous not to take any preventive medications because the best window of opportunity to treat malaria with a booster dose is in the first 2 days when you get very mild (difficult to recognize) first symptoms! Often people don't recognize the symptoms and think that its nothing and it will go away but that is where the danger lies! You ignore it and miss the best time to attack it. Some forms of malaria will lead to death within 8 hours and no medication or standby will help if you are not already on some type of prophylaxis. Medication will not prevent you getting malaria but it will help you with surviving it because your resistance systems has a good head start! I have seen people who took medication and still getting malaria but they were hardly sick, a bit of sweating and flu type of reaction and others (a whole family) who were not on any medication who got malaria and had to be hospitalized, pissed black as tar and had to be evacuated! That was the end of the journey for them and that is the difference between taking medication and not taking medication!

Having that said, you always have to take additional measures in the late afternoon before dusk like spraying, long trousers, socks, long sleeves, light colours, impregnated nets and don't sleep on the ground.

cheers,
Noel
exploreafrica.web-log.nl
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Old 7 Aug 2011
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IMHO, the magic word, is prevenertive meds all but garenteed,
I would try one med if you get the side effects then Stop & use the others, easy to do when not 'in country'

Malaria is no joke, I have it for life, I cought it in 1980 whilest serving in the Army, we had to take 2 Anti Malaria Preventertive meds every day, we would do 6 week LRRP Patrols that was a tub of meds per man, as stated I contracted Malaria after returning and taking the last course of meds (6 weeks),

2 months after I was rushed in to hospital after blood tests etc confirmed I not have it for life.

Remember not just meds but long sleeves long trousers & hat with mozzie net if really dodgy area, and mozzie net at night.

Don't for get the Mozzie Repelant as well.
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Old 7 Aug 2011
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Selous, you do not need to have malaria for life. You can take a course of Primaquine, which will kill the parasite in its liver stage. Other anti-malarials do not clear the liver, hence the recurrent features of some varieties of the parasite.

There is a blood factor which needs to be tested for before you take Primaquine. Any doctor can take care of this part for you, but some don't know much and need to have their hands held.

Hope this is useful information. If not, please feel free to ignore.

Mark
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