Doxy is in the medical sense not an antiprofilaxe but a antibiotic! It is known that antibiotic work against malaria but do you want to take antibiotics for a year, or two? I think if you devellop resistance againts antibiotics you'r in a world of trouble!

NEVER go into malaria area without taking profilaxe, the "I am on standby" system simply does not work because the most effective time to fight an upcoming malaria is during the first two days where it reveals itself with only very mild symptoms which make you wait for another day or so to see how it goes tomorrow. When you are starting to feel sick enough to get worried, you'r TOO late!! That is the big problem with malaria, it start off very mildly, like nothing to worry about, but you'r wrong. Last weekend 2 Dutch tourist died of malaria in Gambia, they did not take any profilax.

In Africa they have widespread available the Chinese 'wonderdrug' Artesunate or what ever name it carries but usually it contains ARTE. This is proven and cheap.

Myself, I have been on Lariam (myflocine) for a year, no problems what so ever but maybe I was lucky because some people are sensitive for the side effects (only 2%!!!)

cheers,
Noel

Having lived in worked in Africa for the past 5 years & contracted malaria 6 times you might find it strange that I continue not to take any form of anti malarial drug. I do however, have a good supply of coartem which is a form of the Chinese wonderdrug as a cure. It does the trick pretty good, second day of the 3 day course and normally I'm felling OK.

Available in major cities for a very resonable price in Africa. Wouldn't know where to get it in Europe or the US.

Not to say I don't take other precautions against malaria such as sleeping under a net, spraying my room before sleep and using repellant when available.

Yes malaria is a killer especially to pregnant mum's, kids under 5 & people with concurrent conditions such as thyphoid.

There have been more deaths in my small town here in Sth Sudan since they fixed the road than malaria deaths. Now everybody is recklessly speeding, literally causing carnage outside my residence. Will that stop people from overlanding through Africa?
CJ.

Yes, the key difference between residents and locals who are not taking any prophylaxis is that they have (normally) already attracted malaria several times so your bodies have built up some resistance, usually just enough not to die when you get it again and in any case you will recognize it in an early stage.

But for overlanders who's resistance system have never seen anything like the malaria parasite, the situation is quit different. It is essentially the same as 500 years ago when the Spanish invaded South America and caused havoc under the indigenous with a simple flu virus! They had no resistance at all and died by the millions. Neither do we overlanders have any resistance against malaria! And that is where the prophylaxis comes in! It won't prevent you from attracting malaria but it will prevent you from becoming fatally ill due to total absence of resistance!

Equally important as the prophylaxis is indeed prevention; before dusk put on long trousers, socks, shoes, repellent especially around the ankles, sleep under an impregnated mosquito net and avoid sleeping on the ground as the malaria mosquito has it working territory at low levels (around 30 cm), the obvious really!

Greets,

Noel

Hi, i just wanted to contribute 1 thing to this discussion:

on a 2 year long African overland trip i got malaria while staying in Zanzibar. I was carrying Malarone as treatment (didn't use it as prevention) and took the prescribed quantity of pills as treatment. It didn't help at all. After three days (could barely walk or lift my arms anymore) i went back to the doctor and got some local medicine (don't remember the name). Felt fine a few days later.

So malarone might not be the miracle stuff some doctors make it to be either.

Koen

I was in South Africa and Swaziland in May. My US travel doc said that Malarone was the only thing that worked with the strains out there today. She thought that taking it as treatment, not as preventative, was a mistake. When I got to Africa, the staff at the safari lodge didn't use anything because they were there year round and the side affects of long term use were unacceptable. Bring back DDT.

Hi

You must be medically qualified to make such a statement, which goes against a great deal of current medical advice on taking Doxy for Malaria?

I think Doxy is usually two tablets a day when prescribed as an anti-biotic. One tablet a day as a long term malarial prophylaxis. But I'm no Doctor.

To me thats an advantage, if I have something that my medical guide books and the small amount of knowledge gained from several wilderness type first aid courses suggests can be treated with such an antibiotic I have them to hand already.


Jason

Hi Grizzly,

What I state is factually correct and you draw conclusions that I don't draw. I pose a retorical question about taking an antibiotic against malaria while there are alternatives specifically designed against malaria!

Also, if you need treatment, antibiotic is sometimes used together with a strong dose of prophylaxis.

Cheers,
Noel

As a for instance, paracetamol is a pain killer when taken as prescribed. Taken at bigger quantiities than prescribed it becomes something else.

The point I was making is if prescribed at one tablet a day Doxy is not at a strength to be an effective antibiotic. So you describing its use as a prophylactic also as being an antibiotic is not really correct (you would have to double the dose or more for that), and it won't have as bad a long term effect than it or any other drug prescribed at a strength to act as an antibiotic. It is of course prescribed worldwide as a prophylactic, and both by my GP and travel clinic nurses in fact because they know I will be taking it for perhaps a year or more. Malerone would perhaps be better but at what cost for long term use, and then I can't change dose of the Doxy if I have something it could treat.

Many people develop resistance to certain antibiotics just from the amounts given by their GP, but there are always(?) alternatives available to them. You suggest the results of taking doxy long term is a thing to be avoided which as I said does go against all current general medical advice available to me. I think you are over stating your case in a dramatic way which does not help this thread. The only assumption I made was that you must be medically qualified. The rest of my previous post was as told to me by medical nurses and GPs, some of which are experts in travel medicine, but I can't type here that you can definitely change your Doxy dose from one to two a day to start acting as an effective antibiotic as I'm not qualified to do so!

Cheers

Jason