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-   -   Malaria Treatment in the Bush (http://www.horizonsunlimited.com/hubb/staying-healthy-on-the-road/malaria-treatment-in-the-bush-35942)

Travelbug 15 Jun 2008 18:51

Malaria Treatment in the Bush
 
Hi,

has anyone in this forum made personal experience with malaria?

I am wondering how Malarone, Lariam etc. work if taken (in a heavy dosis) as a cure instead of a precaution.

Has anyone in the forum ever taken a heavy dosis, without a doctor, while in the bush?

Some travellers say that there is good local treatments in Africa, even in remoter areas, to the extent that they don't take any precautions any more.

I will be in Congo, Cameroon and Gabon for several weeks and I really need to consider if I want to take Malarone over an extended period of time.

Nixa 15 Jun 2008 19:18

These are not questions for forum!
Go to a doctor and ask, don't play risk with these things

Walkabout 15 Jun 2008 19:47

There are quite a few threads in here already about similar questions and discussions - do a search for the keyword of your choice.
As one contributor in here:-

http://www.horizonsunlimited.com/hub...reatment-22410

says, lots of General Practice Docs in the UK know next to nothing about Tropical Diseases.

docsherlock 15 Jun 2008 21:25

Malaria
 
Don't piss about with malaria - it can kill you quickly. You need a full protection package which includes the mainstay of bite avoidance - long sleeves, insecticide treated mosquito nets and repellant and clothes treated with repellant as well as taking the appropriate prophylaxis; it is important to realize that taking the prophylaxis does not guarantee you won't get malaria.

You need to take the right stuff at the right time for the right duration and be alert to flu like symptoms, headaches, chills and sweats etc even after you return - most UK GP's will be able to give you sensible advice or a specialized travel clinic will be even better. You are right that the same drugs are used for treatment as prophylaxis but in different doses and regimens - if you have been taking a particular drug for prophylaxis and you still get malaria the treating doctor may give you a different drug again as the parasite may be resistant to the drug you were taking.

Finally, be aware that many drugs available in the third world are counterfeit - take your own supply bought in a first world country from a reputable source - i.e. not from the internet. I suggest seeking medical advice before you go from a reputable travel clinic.

I reiterate - do not mess around with malaria - it is a killer. Take good medical advice and follow it and don't skimp on the drugs or other precautions. Seek advice from a reputable doctor and clinic if you feel at all unwell in a malarious area - it can have a variety of presentations; even if you don't have it you may have another mosquito-borne disease such as Dengue Fever which although just uncomfortable the first time you get it, can kill you on subsequent occasions.

SW

Travelbug 16 Jun 2008 06:14

Nixa,

you'd be surprised how little doctors in Europe know about tropical diseases.

You'd also be surprised how knowledgeable doctors are in tropical countries.

I have had my share of tough diseases in the tropics - although luckily not malaria - and I'd always prefer to be in the best hospital in a tropical capital, as opposed to an average hospital in Central Europe, or worse, the UK.

Again: anyone who has made personal experience with a TREATMENT of malaria - as opposed to prophylaxis ? Maybe with Malarone?

P.S.: Walkabout, your link was useful. They refer to a successful treatment called Arthenam, available in Africa, but not in the US or Europe.

Walkabout 16 Jun 2008 14:56

Quote:

Originally Posted by Travelbug (Post 194548)
P.S.: Walkabout, your link was useful. They refer to a successful treatment called Arthenam, available in Africa, but not in the US or Europe.

Thanks Travelbug.

It's an interesting question that you pose and a good variation on the other threads that have discussed the pros and cons of malaria prevention and treatment.
Hopefully some more information about Arthenam may come forth.

MotoEdde 16 Jun 2008 15:46

Having had it twice...once about 8 years ago, and a second time in 2007, I'll give you a quick brief...

The forum venue is not a sufficient place to provide you anything more than guidance of where to go to get information. Unfortunately, your local doctors don't have the experience or time to develop a good understanding of something that occurs worlds away.

Malaria is a complicated thing...do you research on the CDC website for starters...

CDC - Malaria

WHO | Malaria

MotoEdde 16 Jun 2008 15:52

Quote:

Originally Posted by Travelbug (Post 194548)
Nixa,

you'd be surprised how little doctors in Europe know about tropical diseases.

You'd also be surprised how knowledgeable doctors are in tropical countries.

I have had my share of tough diseases in the tropics - although luckily not malaria - and I'd always prefer to be in the best hospital in a tropical capital, as opposed to an average hospital in Central Europe, or worse, the UK.

Again: anyone who has made personal experience with a TREATMENT of malaria - as opposed to prophylaxis ? Maybe with Malarone?

P.S.: Walkabout, your link was useful. They refer to a successful treatment called Arthenam, available in Africa, but not in the US or Europe.


TB,
You're right on about which doctors have the experience to offer advice...the local doctors in the area where the disease is more often prevalent.

Having said that, the use of prophaxis must be carefully considered...

For one, the prophalaxis efficacies are vary regionally due to the fact that the parasites have developed resistance to some of the prophalaxis in certain regions.
Also the prophalaxis and 'eraser' drugs such as Arthenam/Fansidar have effects that are possibly more disastarous than the malaria symptoms.

Threads with recommendations of usage based on a singular experience are dangerous...
http://www.horizonsunlimited.com/hub...reatment-22410

kentfallen 16 Jun 2008 16:48

There are loads of sites where you can obtain this kind of information and I agree you'd be better off talking to a medical professional who has direct experience of treating Malaria (not neccessarily your GP).

My understanding is that any Anti-Malarial Drug can be used to treat the disease providing it's a different drug from what you're taking every day to stop getting the disease in the first place.

I find doxycycline to be the best drug for ease of use if nothing else. Larium is needed where the threat is high.

I have had 2 bouts of Malaria! The first one in 1994 nearly killed me (caught in Lagos Nigeria working at the airport) P. falciparum! It was the most horryfying thing to experience so far away from home. My employer (the UK government) flew out 2 specialists from London together with a shed load of equipment to save me. I spent 1 month in hospital in Lagos (not a pleasant place at the best of times).

Docsherlock is 100% correct in his appraisal above.

Whatever you do DON'T listen to all those pillocks out there (including on this forum) who will tell you not to bother with anti-malarials! You know the kinda idiot - it's all part of the adventure ect... I remember meeting a whole family in Banjul The Gambia a few years ago, they had flown out on a late deal without taking any knid of anti-malarial precautions! When I forcibly told them I just got a blank expression and was then told to mind my own business and piss off! I felt sorry for the young kids...

I'd contact the London Hospital for Tropical Diseases or somewhere similar...:smartass:

The Hospital for Tropical Diseases is dedicated to the prevention, diagnosis and treatment of tropical diseases and travel related infections.

ABOVE ALL REMEMBER TO IGNORE THOSE IDIOTS WHO TELL YOU NOT TO BOTHER WITH ANTI-MALARIAL PRECAUTIONS!
Stay healthy and safe.

MotoEdde 16 Jun 2008 17:34

Personal opinions proffered within the forum on medication use is pointless.

We have no idea of the individual's medical history or the area he will be travelling to...he may be allergic to sulfur based drugs, etc....or the 'eraser' drugs once he leaves the malarial zone.


The existing malaria drugs although help mitigate the risk of malaria are not innocent in their side affects...which can be equally dangerous.

Lariam (mefloquine) Information

Malaria Information Page - The Travel Doctor


Bottom line, do your research and make an informed decision...this is not something to be lazy about. Also, if the individual chooses not to use a drug after researching the issue, its his choice/body. Respect it and don't call him an idiot for doing so.

...

Travelbug 16 Jun 2008 19:04

Hi Motoedde and Kentfallen,

thank you. Very good links.

It was new to me that prophylaxis like Malarone can be taken for a year and others up to five years.

I have taken Malarone on a number of trips (up to 4 weeks) and never had side effects. In addition, I always took repellents like no-bite and put up mosquito nets. However, on every trip I did get the occasional mosquito bite.

On the upcoming trip to Congo et al., I will take Malarone, although it's for two months. I'd be keen to get hold of a pack of Arthenam in addition.

Kentfallen, from your experience in Lagos, what went wrong in the treatment (4 weeks hospital) ? Did you get it too late, or is it simply not sure that the medication will show a quick effect? Where did you catch the second one?

I would have thought that in places like Lagos, expatriates don't take prophylaxis (simply too long) but there exists a standard emergency medication in experienced expatriate clinics.


I've had scrub typhus (30% fatality rate) in Malaysia 15 years ago - and got cured in a great hospital in the capital. Got amoebia in Turkey about 25 years ago, sweated it out, but was put in quarantaine back in Europe.

kentfallen 16 Jun 2008 20:36

I contracted Malaria after only working in Lagos Airport for only 6 weeks but before that I was in Luanda Angola. I was taking prophaxis - Doxycycline (which was being used by all my mates in Lagos because it was so easy and didn't have serious side-effects). Some idiots didn't take a thing and I heard deaths sometimes occured.

If you go to any hospital in West Africa during the rainy season, you will find all of them full up with locals suffering from Malaria. If the locals get it and die then we are at immense risk. I remember visiting Banjul's main hospital in July and the whole place was heaving with childran and women. It's terrible to see these local people so desperate.

My symptoms were classic - feverish attacks, shivering, shaking, influenza-like symptoms, tiredness etc. The strain of Malaria I caught caused the Mother of all Headaches, so bad I needed Morphine to control it! I fell into a coma for 4 days in the middle. But the serious problem was my ticker which went into Tacicardia (high rythem). Nothing they did helped not even stopping my heart and electric shock! I am told these problems were caused directly by the Malaria. My heart is now 100% Okay with no long term damage.

The actual attacks of malaria develop when the red blood corpuscles burst, releasing a mass of parasites into the blood. The attacks do not begin until a sufficient number of blood corpuscles have been infected with parasites.

It is rare that a Briton becomes entirely immune to malaria, because this requires repeated bites from malaria-carrying mosquitoes, practically every night for several years. In the worst affected areas, children who live to the age of five years become immune

In malignant malaria the illness may evolve with a number of complications:
  • low blood pressure (hypotension)

  • kidney failure

  • possible haemorrhage (bleeding)

  • effects on the liver (eg infectious jaundice)

  • shock and coma may also develop

  • the condition may prove fatal.
If I were travelling into the bush where medical help was a long way off I would always ensure I had the means to treat Malaria. You need 2 drugs - one to avoid getting it and another to treat the disease if you get it.

The second time was in Banjul, Gambia and this time it wasn't so serious. A few days in bed with fever and I was as good as new. I suppose I now have a limited degree of resisitance but who knows?

Travelbug 16 Jun 2008 21:19

Sorry to hear about the severity of your Malaria attack in Lagos! Good that you could beat it completely and maybe have resistance.

And you got it despite doxycycline prophylaxis !!! This is very useful information. I feel confirmed that one should always take along some malarial cure (at least in addition) when going in the bush.

I understand what you mean with the suffering of the locals.

Years ago I was in Kenya without taking any Malaria prophylaxis. Befriended some young Massai guys. They told me that THEY still get it, " and everytime it feels like dying".

Ever since, I have taken prophylaxis - and avoided getting bitten.

noel di pietro 16 Jun 2008 21:23

Arte...
 
Quote:

Originally Posted by Travelbug (Post 194548)

P.S.: Walkabout, your link was useful. They refer to a successful treatment called Arthenam, available in Africa, but not in the US or Europe.

You will have difficulty finding this particular drug in Africa because it is sold under many different names, usually including "Arte-something". This Artestuff is used as a stand-by drug by locals and expats who have had malaria many times before and have built up a certain resistance. Don't even think about following the same line because if you have never had malaria, your body is completely defenceless against it. Think in the line of the Flu brought to South America by the Spaniards in the 16th century. Innocent to us but lethal to the local Indians. Now malaria is never innocent, not even to locals but the ones who did not die have built up resistance over the years. You will often meet feeble, sweating locals suffering from a malaria attack. Observing these people might lull you into a false sense of confidence like "oh, that's not to bad" but they have had it many times before. When a whitey gets it without having taken proper prophylaxis, he/she can be dead within 12 hours. There are a lot of bullshit stories spread around by travellers who think they know but its your life which is on the line. There is only one truth; its very dangerous, take all precautions. Docshelocks advise is pretty sound.

Cheers,
Noel
exploreafrica.web-log.nl

Travelbug 16 Jun 2008 21:30

... did not want to appear light-hearted at all. On the contrary.

This disease is my only big worry whenever in Africa.


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