I did the same just have some pills with you in case you need them. The next hospital might be a few days drive away...

Adventure Motorbike expedition through africa - Transafrika part 1

To protect your selfe just use a tent with mosquito net and long sleve clothes in the evening at the fire place...

thanks Ta rider

Buy the insect repellent that the locals use - in southern Africa we use Tabard and Peaceful Sleep. Those together with covering up between sunset and dawn worked for us.

I attract mozzies and react to their bites here in the UK but I can honestly say that in our travels in southern Africa I hadn't as much as 1 bite.

We didn't take the tablets because of previous reactions to them.

greater than 90% of travellers who contract malaria upon returning home did not take anti malarials. All the people we met travelling in Africa who contracted malaria were not taking anti malarials. Maleria itself is not very prevalent in South Africa but once you are in central Africa it is endemic. You should cover up and use repellent and mossie nets wether you take anti malarials or not. Anti malarials such as doxycycline are relatively safe, and very few people have negative side effects from them. Maleria is a debillitating disease, potentially fatal and mostly preventable with sensible management

My thoughts - 3 years around Africa, west coast and east coast:

- I didn't take anything and didn't get Malaria. I carried 3 packs of Coartem in case.

- I religiously covered up each night well before dark with thick socks sprayed with stuff, thick jeans and long sleeves. I would put spray on top of my hands as they often landed there otherwise. They never bit me on the neck, sometimes on the cheek.

- When getting into my tent each night I would spend a minute with a light looking for them before sleeping. If staying in a bad area I would usually spray the tent with fly spray 30 mins before bed time.

- Watch out again in the morning.

- Watch out even in daytime in shade or near water in shade - like the wash area out the back of a building for example.

- The only other long term travellers I meet who didn't get Malaria were a couple who plastered each other with creams/sprays each night the same time as me.

- Most other people got it, and once they got it once they often got in 3-4 times over a few years. My general impression was they didn't take covering up seriously enough, often too busy having a and waiting until they had been bitten a few times before covering up. It's hot and sticky and its a pain to cover up. I generally found that people I thought would get it did because you could see they were lazy towards not getting bitten.

- Its hard to get kids to cover up or stay covered in spray.

- Some of it is luck.

- If your a couple it seems more likely you will get it, once one has it chances are another mossie will pass it to the other one.

- I meet loads of people who were taking something and still got it. None of the drugs prevent you from getting it, they will lessen the risk, some may help slow the symptoms down hopefully enough that you can get treatment, such as Malarone I believe?. You can get self testing kist (accuracy?) and if you carry two different treatments and understand them, you might be ok if stuck in the bush days from anywhere. Know how to take your temperature for example. The best policy is not to get bitten!

- None of the drugs are suitable for taking for long periods - over 6 months - and I wouldn't want to take doxycycline (an anti-biotic) for a long period, its not healthy. It's about balancing the risk of Malaria against the longer term impact of the drugs on your body, for me at least. The drugs are all pretty harsh..

- I helped quite a few people to and in hospital with it. When it was the first time they were usually reluctant to go as getting to he hospital can be a pain in the arse etc. It's no fun for anybody.

- People often relapsed a few weeks after their first case as they start to feel 'normal' again after about 10 days so continue with hard traveling, drinking etc, but it seems the body needs longer to truly fight it off. Spending two weeks afterwards doing nothing and being healthy seems best.

Doing it again I'd do exactly the same again. Try to understand the risks, assess them to your situation, prepare for the worst case scenario and if you get a fever, stop and see what it is.

There's a lot of wisdom in #6, but some misinformation as well. For example, while the correct antimalarial drug will not prevent malaria 100% of the time, it will prevent malaria most of the time. That's very different from "all they do is slow the symptoms down hopefully enough that you can get treatment." Of course, it is still necessary to be prepared to get proper treatment in the event that you come down with acute malaria, no matter what drug you choose to take (or not).

It is also a matter of opinion whether "None of the drugs are suitable for taking for long periods - over 6 months." Compared to the effects of contracting malaria or to the possible effects of heavy use of insecticides and repellents, the effects of anti-malarial meds can seem like the best option....depending on everything under the sun, of course. For example, my first time with acute malaria I ran a 106 F (41.1 C) fever and almost died. For example, there are all sorts of studies on repellents and insecticides, including the effects of long-term use. Use your critical thinking skills and make your own informed decisions.

One likely reason for repeated bouts of malaria is that two of the five forms of the disease are recurrent. When taking the cure, it's important to know that if you have one of these two varieties you may need to take a second drug as part of your cure. This second drug is Primaquine.

Finally, the test kits available in my country are not reliable--they test for some varieties of the parasite but not others. I don't know about other kinds of test kits, but I'd suggest a dubious attitude. Even blood tests are only as good as the people who read the slides, and they won't show a dormant infection (during which the parasites are not found in the blood). Caveat emptor.

Best source of balanced information on malaria is a poster named "nutraxfornerves" on the Lonely Planet Thorntree forum Health Branch.

Hope that's helpful.

Mark

Thanks for your thoughts mate - I speak only from my own experience, I'm not a doctor, but I looked at the risks in detail for myself...

Malarone is supposed to be the great new drug, but I meet 4 people on it who came down with Malaria. They had all purchased it in their home countries. (fake drugs are huge problem in Africa, so its important to ask where somebody bought each box from etc)

Will 'they' actually prevent Malaria? Or just prevent the onset of fever/symptoms for a while? We probably need to break it down for each drug, sorry for the generalisation, but it is my overall impression - nothing will stop you from having Malaria anywhere near to 100%. Drug companies may claim otherwise!

Certainly my impression of hanging out with peace corp people on a previous trip was that Doxy just slowed down the onset of the symptoms. They were all required to take it for their 2 year stay and that was the experiences they told me. Hard to know how many cases it 'stopped'....

In the UK the advise is not to take any of the meds for more than 6 months.

Look at the huge list of side effects of each drug as well. For me it was a case of Larium is just plain awful (previous trip, bad dreams, hair loss), Malorone too expensive and not recommended for more than 3 or 6 months(??), Doxy an antibiotic would make my fair skin even more sensitive to the skin and I don't like the idea of pumping myself full of antibiotics for years.... and so on....

I used clothing because I didn't want deet on my skin, but Citronella based creams seemed to work well and were natural enough.

Its a difficult area - doctors will always say to take something to cover themselves and because they work to some degree.

Worth reading up on the cures as well as the prevention. Most are based on a plant with a cocktail of drugs added to try and prevent resistance buildup.

Artemisinin - Wikipedia, the free encyclopedia

Thanks for the shared thoughts, all interesting....