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-   -   Do I need anti-malarial out of season? (https://www.horizonsunlimited.com/hubb/sub-saharan-africa/do-i-need-anti-malarial-31877)

Tim Cullis 27 Dec 2007 13:29

Do I need anti-malarial out of season?
 
According to the World Health Organisation website, the transmission of malaria in Senegal and southern Mauritania takes place for between two and six months in the period June to November.

So if I am going in January, do I need to take anti-malarial drugs?

Tim

Walkabout 27 Dec 2007 14:02

Quote:

Originally Posted by Tim Cullis (Post 165263)
According to the World Health Organisation website, the transmission of malaria in Senegal and southern Mauritania takes place for between two and six months in the period June to November.

So if I am going in January, do I need to take anti-malarial drugs?

Tim

Tim,
In a word, no.

ps There are other threads in here which discuss a whole range of issues about such drugs; one theme is about non-qualified people giving advice about such matters - before that starts again :rolleyes2:, please make up your own mind. :innocent:

jim 29 Dec 2007 14:44

Agreed. Having read the backs of several anti malarial drug packages, trying a few and traveling often in central Africa without getting malaria I consider myself practically a doctor and therefore well positioned to agree with Dave... Er, there was that one time in Malawi I got malaria... but only once (and I was actually taking medication at the time, though not as often as prescribed...).

There- problem solved.

Walkabout 30 Dec 2007 00:33

Thanks for the corroboration
 
Well Jim, my answer is based on medical advice while I was working abroad; my employer provided anti-malarial prophylaxies (or however they are spelt) as part of their contract when their medical staff advised them to do so, but they did not provide them "out of season", again as advised by the docs.

Cheers,

Hindu1936 4 Jan 2008 14:56

Continuing in this vein: We expect, hope--to enter Morocco in January and ride pretty steadily south hoping to reach Namibia in may before the rainy season begins in the more northerly countries. Could we safely forego the malaria meds until we reach South Africa and head north up through Botswana to Zambia? I hate to put drugs in the system but think I would hate more getting malaria.

bmw.bec 4 Jan 2008 20:11

Out of season in the northern part of Africa - it can be safe to not take malaria tablets but central africa is a different story and I would never risk it.

Unfortunately I think alot of people view malaria too lightly on here and previously mentioned by walkabout most advice is given by people with travel knowledge and no medical training.

Personally after having studied tropical medicine, I would always take my malaria tablets.

manfredschweda 5 Jan 2008 08:17

Malaria
 
2 things on Malaria: 1. You still can get it when you try to prevent it (I have seen a French family all on Malrone, 50euros a pack, all 3 ill of Malaria last summer in Mali, who said to themselves it cannot possibly be Malaria as they take tablets, and got seriously ill, means infusions and hospital)
2. Malaria, at least the usual down here falciparium tropical type is one of the easier curable diseases. A pack of Coartem for 8 Euros usually does the job in 3 days. See a doctor early, do a test early, Treat it early. Have a pack on you when you fly back.
I prefere the second.
rgds Manfred, in Bamako, had it 4 times in last 2 years.

markharf 5 Jan 2008 19:49

I got malaria in Mali, perhaps contracted in Ghana, during December dry season. Having had it before, it was easily recognized and easily treated. I did lose a good chunk of my trip to the acute and recuperation phases, and I remained weak for quite a while. You want a holiday, or would you really prefer to be a walking, talking experiment? Note that the first time I got malaria I almost died, which does suggest not messing around unduly until you know more about what you are up against.

You will make your own decision and are welcome to the consequences, good or bad....but I take malarone against any possibility. The cost is minimal, considering all else.

Hope that helps.

Mark

(from Tafraoute, where anopheles and plasmodium are blessedly absent)

manfredschweda 5 Jan 2008 20:03

Malaria
 
Why did you nearly die? Because you did not go see a doctor when you had the Symptomes? All I wanted to say, even with Malrone you wont be save, if you get bitten many times. which is too common here. But you may think you are save and don't consider Malaria, denie it, it also may hold back symptomes. And when you finally realise, it might have advanced to a severe state.
A test here is done very cheapely, everywhere. Medication like Coartem works!
http://hugin.info/134323/R/991237/149239.pdf
Rgds Manfred

markharf 10 Jan 2008 21:46

Manfred, you and I are just datapoints. Neither my experience nor yours will necessarily relate at all to that of the original poster, who asked basically whether there is malaria present during dry season in a certain area of West Africa. My answer is yes, there is, and that I think this is worth taking into account.

I'm well aware that you can get malaria while taking Malarone or Larium or whatever. Actually, this has happened to me. However, as I understand it this is far less likely, and in addition is likely to be far less severe if it does happen. I am also aware that the first line of prevention is keeping Anopheles from biting you around the ankles under the dinner table every night (which is their preferred mode of attack). I presume that Tim, the OP, who has demonstrated himself perfectly competant and capable, is aware of this, too.

I almost died because I was back in the States and not thinking malaria until it was almost too late. I was found by a friend almost comotose, unable to move with a 106 degree (F) fever. You know better, having had the disease, and now I do too. But the OP might not....or might forget after returning home. In my view, relying on the availability of a test is akin to wishful thinking, but maybe that's just me. In the States, a test kit had to be shipped to my Dr. from a nearby city to the island on which I lived, as did the treatment. Waiting for the test would have cost a couple of days, which from my perspective at the time was not to be desired. By that time, I'd figured it out, so I convinced my Dr. during one of my more lucid phases.

Again, we're all just presenting possibilities for consideration. Hope what I've offered helps someone, somewhere, at some point. It's not a pleasant disease with or without the cure.

enjoy,

Mark


Quote:

Originally Posted by manfredschweda (Post 166726)
Why did you nearly die? Because you did not go see a doctor when you had the Symptomes? All I wanted to say, even with Malrone you wont be save, if you get bitten many times. which is too common here. But you may think you are save and don't consider Malaria, denie it, it also may hold back symptomes. And when you finally realise, it might have advanced to a severe state.
A test here is done very cheapely, everywhere. Medication like Coartem works!
http://hugin.info/134323/R/991237/149239.pdf
Rgds Manfred


Hindu1936 11 Jan 2008 05:02

Thanks everyone. It seems that the consensus is to take the meds, wear long socks and pants treated with peremithron, and use a good DEET spray. Simple precautions that might save a big hassle and it also appears that there is no time that a person is completely safe. We will follow the advice and hope fpor the best, but if symptoms do appear will head for the nearest clinic and carry the coaratem.

Walkabout 11 Jan 2008 10:52

Prevention is better than cure
 
Quote:

Originally Posted by Hindu1936 (Post 167726)
Thanks everyone. It seems that the consensus is to take the meds, wear long socks and pants treated with peremithron, and use a good DEET spray. Simple precautions that might save a big hassle and it also appears that there is no time that a person is completely safe. We will follow the advice and hope fpor the best, but if symptoms do appear will head for the nearest clinic and carry the coaratem.


On the issue of prevention:

You don't mention using a mozzie net for sleeping under - worth taking one perhaps?
Also, from dusk, roll down sleeves/long sleeves to be worn , long trousers if you have been wearing shorts during the day; basically "cover up" during hours of darkness when the mozzies are most active - used to be called "Planters' dress/rig".

Hindu1936 11 Jan 2008 12:17

You bet we will carry one of those mozzie nets that hang for the ceiling for use in hotels and our tent will be saturated in DEET, coated with permethron, and have a mozzie killer light. Also, when I worked in Alaska, we used Avon pretty feet and it worked better than anything else for keeping those monsters at bay. We plan on making total war on the blasted beasties. Don't know if those gadgets that are supposed to emit a sound that keeps them away work or not, but we will give them a try as well. As cheap as they are, about 8 bucks each, it's not enough to worry about and if they do work, worth 10X the price. I haven't seen anyone posting about them. We have only one more trip to the clinic to finish off the jabs, then keep working until the cash is up to the level we need for the trip. The only thing lacking now as far as equipment is the water purifier/filter. There are probably somethings that we haven't thought of yet, but so far, so good.

jim 11 Jan 2008 17:56

I know Im going to get flack for this one but there is very little African perspective on this site so here goes:

What is it with you "first worlders" and this paranoia about Africa? Im making a sweeping generalisation here but you guys just love the kit dont you? Water purifiers, GPS, sonic mozzie repellants, tent burglar alarms.... cummon chaps youre coming to Africa for an adventure you not going to the moon! Sure try avoid the bugs and be sensible, but remember there are millions of us living here without water filters and daily DEET baths. Your dont need snake bite kits, you can ask for directions and shit man if you get bitten by a mozzie (which you absolutely will) then smile and deal with it, its part of the experiance man!

kentfallen 12 Jan 2008 01:04

NO ONE but no one should be telling anyone to stop or not to take anti-malarial prophylaxies ! Thats a fact! If you have done so then may I suggest you STOP giving out this advice in case someone becomes very ill as a consequence. Any Doctor will tell you that Malaria is an endemic problem in Sub-Saharan Africa the whole year round not just the rainy season. Sure the incidence of Malaria is much higher in when there's water laying on the ground but many many people contract it in the dryer months too.

I caught Malaria in January 1993 (the dry season) whilst in The Gambia! I caught a strain which will remain in my blood forever more and it made me extremely sick indeed! I owe my life to a Swedish Doctor who provided treatment to me through the British High Commission in Banjul. In 2003 I once more contracted Malaria after spending only 4 days in the Airport at Lagos Nigeria! This time my symptoms were not so serious and after 4 days rest I was judged well enough to return to the UK.

I have worked all over Africa since 1991 and since then have had many many friends who have been struck down with bouts of Malaria. One White European aquaintance died after getting Celebral Malaria in Kenya. I have also personally seen many local (black) people die including children.

DO NOT UNDERESTIMATE THIS DISEASE WHICH KILLS 1 MILLION PEOPLE EACH YEAR IN AFRICA ALONE (mostly children with no or low immunity)!

If you phone the London Hospital of Tropical Diseases, they will tell you to take precautions in addition to taking anti-malarial prophylaxies. By precautions I mean covering up exposed skin and limiting the places you go at dusk and night time. Get a good strong DEET cream or spray and make sure you use it. Forget anything other than DEET, nothing else works properly. Above all at night always use a good net and spray some DEET into it before you retire for the night.

You can NEVER be 100% protected but if you use the correct tablets for the area you are visiting it should give you about 80% protection.

Oh yes, make sure that you take with you at least one other type of anti-malarial prophylaxies to use in the event you do contract Malaria. It's no good using the tablets that failed to protect you in the first place.

I know that many people are now using DOXYCYCLINE (or something spelt similar) this is an anti-biotic normally used to treat infections but it has been proven to give good protection in areas of Africa where Celebral Malaria (the killer strain) is prevalent.

GET SOME EXPERT ADVICE AND STOP PUTTING YOURSELF AT RISK!

As for those on this thread who treat Malaria as something that all travelers should experience as part of the trip experience, you need to grow up! You insult millions already lost to the largest killer on earth...

Stay safe and ride carefully...

Hindu1936 12 Jan 2008 01:55

Naw Jim, you won't catch any flack from anyone on this site. Hell, we all say something totally stupid once in a while. While we are not protecting ourselves from one of the biggest killers in the world, Malaria, let's all go to India and quit eating so we can join the biggest killer in the world: starvation. Really get into it and enjoy the pangs of pain and the sense of delirium that true hunger offers. Then maybe we can go to Thailand and jaywalk and join the 96 people a day killed in traffic. Not a good idea?? We should protect ourselves where and how we can? Well shoot, man, we will miss the experience of joining them. OUr survivors won't have any stories to tell how grandpa took a kayak trip down the Zambia River because he died of Malaria in Ghana. Nonetheless, thanks for your advice about the low risk of Malaria, but I will remain cowardly and take my malaria prevention measures, and because dysentery is also a major killer in Africa wiping out nearly a million people a year who cannot get clean water, I will take my water purifier and use it wherever I can't get bottled water. As a Marine commando I was taught to respect my life and do all I could to preserve it.

But because I see the zest in your attitude I sincerely invite you to come to Oregon and go mountain climbing with me. Oh, you don't get snow goggles, crimpons, pitons, ropes, or gloves. This will allow you to enjoy the true spirit of the mountain.

Joe

ChrisJ86 12 Jan 2008 05:22

Perhaps I'm just being a naive first world prat, but, to me, arming oneself with anti-malarial meds, clean needles, condoms, anti-bacterial soap, water purifiers, et al is very different to carrying a GPS, a laptop and other sorts of 'kit.'

Look at the average age of death in most African countries. Sure, AIDS accounts for a good bit of those figures -- but malaria's no slouch either, statistically speaking.

Walkabout 12 Jan 2008 10:23

Quote:

Originally Posted by jim (Post 167833)
I know Im going to get flack for this one but there is very little African perspective on this site so here goes:

What is it with you "first worlders" and this paranoia about Africa? Im making a sweeping generalisation here but you guys just love the kit dont you? Water purifiers, GPS, sonic mozzie repellants, tent burglar alarms.... cummon chaps youre coming to Africa for an adventure you not going to the moon! Sure try avoid the bugs and be sensible, but remember there are millions of us living here without water filters and daily DEET baths. Your dont need snake bite kits, you can ask for directions and shit man if you get bitten by a mozzie (which you absolutely will) then smile and deal with it, its part of the experiance man!

Hi Jim,
What do you guys do about this, in Cape Town and when travelling around the rest of Africa?

Those mozzies get everywhere:-

BBC NEWS | Americas | Yellow fever alert alarms Brazil

jim 12 Jan 2008 16:12

Quote:

Originally Posted by Hindu1936 (Post 167919)
Naw Jim, you won't catch any flack from anyone on this site. Hell, we all say something totally stupid once in a while. While we are not protecting ourselves from one of the biggest killers in the world, Malaria, let's all go to India and quit eating so we can join the biggest killer in the world: starvation. Really get into it and enjoy the pangs of pain and the sense of delirium that true hunger offers. Then maybe we can go to Thailand and jaywalk and join the 96 people a day killed in traffic. Not a good idea?? We should protect ourselves where and how we can? Well shoot, man, we will miss the experience of joining them. OUr survivors won't have any stories to tell how grandpa took a kayak trip down the Zambia River because he died of Malaria in Ghana. Nonetheless, thanks for your advice about the low risk of Malaria, but I will remain cowardly and take my malaria prevention measures, and because dysentery is also a major killer in Africa wiping out nearly a million people a year who cannot get clean water, I will take my water purifier and use it wherever I can't get bottled water. As a Marine commando I was taught to respect my life and do all I could to preserve it.

But because I see the zest in your attitude I sincerely invite you to come to Oregon and go mountain climbing with me. Oh, you don't get snow goggles, crimpons, pitons, ropes, or gloves. This will allow you to enjoy the true spirit of the mountain.

Joe


Ouch!
Im not saying dont take anti malarials, or drink dirty water or do anything that goes against common sense! Im just saying that Africa really is not the dark and dangerous place people seem to expect. Yes there are of course dangers and no its not the French country side, but really there is no need for paranoia. You can travel safely without drinking only bottled water and without freaking out about every mozzie bite you get.

In case nobody picked up the facetious tone of my first post- I was trying to illustrate the fact that Malaria prevention is a very complex issue that requires educated expertise. Its no fun having it and there are many considerations to take into account when going to a Malaria area. In my most humble and uneducated opinion I personally believe in taking medication only when I feel the risk is high. You cannot avoid getting bitten, take the basic precautions (incl medication where applicable) and enjoy your trip.

Joe Id love to come climbing with you! If you come to Cape Town (Where we drink water straight from the taps, scoff at mosquitos and walk around barefoot and in our underpants just for fun) do look me up and we can go for a climb here. I promise to bring ropes and gear- its just common sense!

Jim

markharf 12 Jan 2008 19:24

I´m going to agree with you, Jim (quoted below). There´s a mystique about Africa which tends to get a lot of us into an uproar about health issues. Personally, I´ve had far less G.I. problems in Africa (East, South, North, Central and West) than in South Asia, where giardia, amoebas and, yes, malaria are rampant. I´ve also had more problems related to outdated or phony medicines in Nepal and India. This doesn´t mean I take things lightly in Sub-Saharan Africa, however.

For what it´s worth, I also drink the water just as you do....in Cape Town, where I don´t take anti-malarials or worry about dengue either. Your country is a far cry from, say, Burkina Faso or the former Zaire, where I treat my water and pay a lot of attention to mosquitoes. It´s a big continent, with lots of variation in landscape, culture, flora and fauna.

To the poster who said he´d contracted a form of malaria which remains in his blood, it has been my understanding that this is not the way it works, and I´d be interested in some clarification. There are two types (of the four) of falciparum which have a liver stage which is not affected by most medications. These give the recurring bouts for which malaria is sometimes known, when the liver phase of the parasite transitions into the acute phase, with fever, anemia, etc. However, treatment of the liver phase is easily done with Primaquine, an otherwise less-effective medication. I am not aware of any untreatable form, but I am certainly willing to learn.

There are also some people who cannot take Primaquine due to some sort of blood factor, about which I know little. Perhaps you are one of these....?

Happy topic! Hope my contributions help.

Mark

Quote:

Originally Posted by jim (Post 167833)
I know Im going to get flack for this one but there is very little African perspective on this site so here goes:

What is it with you "first worlders" and this paranoia about Africa? Im making a sweeping generalisation here but you guys just love the kit dont you? Water purifiers, GPS, sonic mozzie repellants, tent burglar alarms.... cummon chaps youre coming to Africa for an adventure you not going to the moon! Sure try avoid the bugs and be sensible, but remember there are millions of us living here without water filters and daily DEET baths. Your dont need snake bite kits, you can ask for directions and shit man if you get bitten by a mozzie (which you absolutely will) then smile and deal with it, its part of the experiance man!



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