Does anyone know how Deltaprim, an antimalarial drug used in Southern Africa, performs as compared to Lariam and Malarone?

Antonio

I took Deltaprim in Zim in 2004 and came down with a rousing case of Malaria on my return.

465H&H

Some of the malaria meds do not prevent the restant strains of malaria..Larium has caused some severe psych problems in some users...
I know Malerone is used to help cure some who have come down with it...
I have used it for two safaris and will use it for the next in 11 weeks...

Mike

Terry, have never thought to ask as I always use Malarone but I assume they refer to Malasone and they are one and the same.

Correct?

quote:

Originally posted by BigBBear:
Terry, have never thought to ask as I always use Malarone but I assume they refer to Malasone and they are one and the same.

Correct?

Wondering the same thing "Malasone" = Malarone??

I Googled it and it appears that Malasone is not the same as Malarone. There is not much information on the web about Malasone.

Malasone appears to be an over-the-counter drug available in Africa and is not FDA approved.

Malasone and Deltaprim seem to have the same ingredients and there is more information on Deltaprim on the web.


Regards,

Terry

A little research on the internet yielded the following:

"malasone" (not identical to malarone) which is pyrimethamine dapsone, not available in the US or approved by FDA, but available over the counter in most southern African ..."

I used Malarone in 2002 and will again next month.

Excerpt from a British Travel Magazine

Take the right prophylactic.

Both the WHO and MASTA are unequivocal in their recommendations for African travel; mefloquine (Lariam) is the first choice of drug, with proguanil (Paludrine) and chloroquine (Nivoquine/Avloclor) as the second option. As a cure for malaria, MASTA recommends treatment with quinine sulphate and Fansidar.

This whole-hearted support for Lariam may surprise those who have been following the worldwide debate over allegations of its harmful side-effects. These range from nausea, insomnia, bad dreams and depression to panic attacks and suicidal tendencies.

The Bristol doctor said he would make sure people were aware of the potential side effects but stressed that, in some parts of Africa, the increase in chloroquine resistance means Lariam is the only effective prophylactic.

Further support for Lariam comes from Dr. Alan Spira of the Travel Medicine Centre in Beverly Hills, USA. His paper "Malaria and the Lariam controversy" claims that "the risk of serious neuropsychiatric side-effects are approximately one in 13,000 - the same as that of chloroquine, which has been used for decades. Aspirin has a 7% rate of adverse drug reactions, which is above that of Lariam, yet no-one sensationalises the dangers of Aspirin," he said.

MASTA states that one in 140 people can experience unpleasant side-effects usually occuring within the first two or three doses.

The price of prophylactics in the UK varies depending on the product, which dispensary makes up the prescription and whether you are eligible for free medication under the National Health Service.

Mr Joel Hirst, a pharmacist with the Bristol-based group Pharmacy Plus said Lariam was only available on private prescription and would cost about 25 for eight tablets. You need to take one tablet per week two weeks prior to departure, one a week while on holiday and one a week for four weeks after returning home.

If you were buying Avloclor and Paludrine, the combination of tablets required would be about 16 for a two-week holiday. These prophylactics are available without a doctor's prescription. However, Mr Hirst stressed that anyone buying over the counter should read the instructions carefully and take the full course.

Another prophylactic which is marketed in the UK under the brand names of Maloprim and Malosone is available only on private prescription at just 6. In Zimbabwe it is known as Deltaprim and is recommended by many local doctors and pharmacists. The drug has been championed by Bulawayo, Zimbabwe, pharmacist Mr Peter Rollason who has battled for years to get it reinstated after the National Pharmaceutical Association removed it from the British National Formulary. Questions about the drug's main ingredients arose over 20 years ago when it reportedly resuld in the death of a user. Studies later showed the death was probably due to an overdose but the drug still remains blacklisted.

At one of the many international conferences he has addressed on the subject, Mr Rollason has described Deltaprim as "ideally suited" to Zimbabwe's conditions. "Far too many visitors are spending more money than necessary on drugs which aren't as appropriate as Deltaprim," he has advised.

Whilst Deltaprim is recommended for Zimbabwe, Chloroquine and udrine are generally preferred in South Africa. Such regional variations stress the need for expert guidance.


From Travel Africa Magazine

I will be traveling to Zim/Lowvelt area...I do not want to take anything before I go. I'm only going for 14 days, what is the incubation period for Malaria? I'm thinking that by the time I get it, I will be home already and I will just treat it IF I get it. Does this make sense?? I think that half the time doctors tell you to take it just to cover their asses!
How prevelent is Malaria in this area in August??

Wolfgar,

I hunted the Zimbabwe Lowveldt the last two weeks of August in 2002. Did not see a single mosquito until the end of the trip. Then I noticed a couple flying around the evening before departure in Bulawayo. When arriving in camp at the beginning of the trip, my PH told me that I probably did not need to put the mosquito nets (over the bed) in the cabin down as it was too early for them.

All that being said, I did get a prescription of Malarone after comments here on AR and some good research done by my general practicioner. I never noticed any side effects with the medicine.

I would not go over there without taking something but that is just my opinion.

Have a good hunt!!!

Phil

You really need to check with a specialist from a tropical health centre about which one is suitable for individual areas. Forgot going to a GP as they don't know squat....... Also ask about any and all side effects.

I'm always wary of clients taking Larium as it can cause so many side effects. A lot of people will take Larium and say it doesn't affect them - I think it sometimes/often does, but they don't realise it. Mix that with firearms and it can be a recipe for an accident. Hence my caution.

I personally seem to be very sensitive to the side effects of these drugs and have found that Malarone suit me best and doesn't seem to have any side effects at all. Doxycycline is good but you need to watch the sun sensitivity and if you take it for long periods it can give you thrush...... either in the throat or the penis.........and take it from a man that learnt the hard way, the latter isn't just painful, it's f***in' PAINFUL!!!!! .... esp when you have to walk all day.....

Whether to take anti malarials or not is a personal choice, but my advice would be - Don't make the mistake of taking the risk of malaria lightly....... it kills a lot of people.

Wolfgar,

If you get bitten by one mosquito carrying Plasmodium falciparum, you might be dead or in a coma before you get home.

Have a nice trip.

Regards,

Terry

P.S.
To answer you question re: incubation. The time between an infectious mosquito bite and the first detection of parasites in a blood smear is generally 6–16 days. Symptoms may not occur at that time and the first presentation of the infection may be delayed for weeks or months. Commonly, clinical symptoms occur after 7–14 days for P. falciparum, 7–30 days for P. malariae and 8–14 days for P. vivax and P. ovale.

This might be of interest. wwww.foxnews.com/story/0,2933,194332,00.html

That should be www.foxnews.com/story/0,2933,194332,00.html

Shakari,

I leave for my first Africa trip on May 19. My doctor prescribed Doxycycline for my wife and I. We'll start taking it 2 days prior, and our trip is relatively short (one week) and then we'll continue to take it for a month after. About 45 days in all. I guess my question is: what is considered "taking it for long periods". Should I worry about Doxy and ask my doctor to prescribe Malarone instead?

I would think 45 days should be fine..... I was taking it for over 8 months. I'd suggest a regular intake of live youhurt or other source of live bacteria though...... the good thing about doxy is that it's a lot cheaper than Malarone and it also helps if you get tick bite fever............

I believe Malarone is more expensive.

On my first trip to Tanzania the County Health Department was recomending Malarone. This was the result of a Tropical Disease Conference attended by the local Nurse.

They were recomending Malarone because of effectiveness without side effects.

I have used it exclusively without problems.

Count me as one of MASTA's 1:140. I will never take Larium (mefloquine) again. I'm not sure I'd rather die of malaria, but I will risk less certain prophylaxis in the interest of skipping the waking dreams and auditory hallucinations next time around.

Thanks very much for all your answers guys, this topic is always interesting. I have taken Lariam on two safaris and only experimented some vivid light nightmares, which I cannot ascribe 100% to Lariam. However many people and doctors hold that Malarone, although more expensive, is a better prophylactic.

My problem is neither of them is sold in Mexico, only chloroquine. On previous safaris I got my Lariam in the BA Travel Clinic in London. However, my present flight schedule does not allow it this time, so I probably will go the Deltaprim route.

Can Malarone be bought or ordered in the USA via the internet without a prescription?

Antonio

just finished a reading a review article in
"Lancet Infectious Diseases March 2006"
'Problem pathogens:Prevention of Malaria in travellers'
I will be sticking to doxy. that I have used with good results in the past.
Article is good read for those with medical knowledge.
Authors are Franco-Paredes and Santos-Preciado

quote:

Can Malarone be bought or ordered in the USA via the internet without a prescription?

Malarone requires a doctor's prescription.

Regards,

Terry

malarone gave me very similar side effects as lariam. I tried deltaprim one and didn't maleria, but who know if I had been bitten. Last few trips I use cloroquin and doxy & it works (but I still don't know if i'd been bitten). tick fever is a common occurance and the doxy takes care of that & i know i've been ticked off before (sorry about that but i just couldn't help it)

butchloc

I had the same problem with Malarone. I used it for about 5 days, had cold sweats and nightmares. Through it away the next morning and never had another problem. Luckily I was not in a high risk area, so I had taken it only as a "to be extra sure" measure.

That said though, the local PH's dont use anything because they say that with different strains out there, you may be using one type of med but the strain that hits you is something else and the medical personel may not be able to figure out which one you have. this could lead to delayed treatment.

quote:

That said though, the local PH's dont use anything because they say that with different strains out there, you may be using one type of med but the strain that hits you is something else and the medical personel may not be able to figure out which one you have.

That is why every now again you get one them in a Rural ER on deaths door !

Here's one PH that ALWAYS takes anti-malarials - but not doxy or larium.......

I bought 24 pills of Malarone today. Start two days before arriving in RSA and continue 7 days after return. My 30% co-pay was $35.00.

Indy, Well worth it. I had to pay full boat, drugs for 10 days in country were $85. Costco as I recall. I need to do a better job of shopping

Butchloc and Hikerbum,

I too got vivid nightmares from Malarone when using it last year as a prophylactic, although I don't recall having this nasty side affect when using it as a cure some years ago (since I was sick from Malaria, I don't know what ailments I had were from the disease or what were from the pills).

The Malarone nightmares were so bad that I won't be taking it again, but will stick to Doxy, which I have used for 9 months with no problems. As long as I took the pill at dinner/night time, I didn't get sunburn problems.

So although most doctors say Malarone has no side affects, this is clearly not true from our 3 seperate experiances.

The current Med of choice in East Africa TO TREAT MALARIA is called Coartem. It is based from Artemether and lumefantrin. No side effects and extremely effective. It is the only drug that works for strain resistant malarias. I always have a couple of boxes with me just in case. Here in Tanzania it is sold over the counter as a stand-by emergency treatment. Not sure of its availability elsewhere in Afric and the world but if you are hunting Tanzania it is well worth buying a box to carry with you despite taking prophylaxis. the dosage on the box is 4 tablets at onset, 4 after 8 hrs another 4 after 24hrs and last 4 after 48 hrs - total 16 tablets.
However, Dr. Saio, who is a leading malaria specialist recommends 4 at onset, 4 after 8 hrs, 4 after 24hrs thereafter for 4 days total 24 tablets.

quote:

Originally posted by Wolfgar:
I do not want to take anything before I go. I'm only going for 14 days, what is the incubation period for Malaria? I'm thinking that by the time I get it, I will be home already and I will just treat it IF I get it. Does this make sense??

About as much sense as not using a condom on a South African hooker and hoping they will find a cure for AIDS by the time you get real sick.

quote:

Originally posted by Wendell Reich:

quote:

Originally posted by Wolfgar:
I do not want to take anything before I go. I'm only going for 14 days, what is the incubation period for Malaria? I'm thinking that by the time I get it, I will be home already and I will just treat it IF I get it. Does this make sense??

About as much sense as not using a condom on a South African hooker and hoping they will find a cure for AIDS by the time you get real sick.

Couldn't have said it better my self.



465H&H

Great malaria reference site.

www.malariasite.com

465,
I am hoping to get some educated opinions here. I guess I am wondering, "is the cure worse than the disease?"
There are some pretty scary side effects associated with Malerone and Larium....If malaria had the same incubation period as say lymes disease, I would get my sorry ass to the doctor as soon as I got back to the states. I didn't think malaria was so deadly in so quick a time frame.
Anyway, today I made an appointment with a specialist, so in two weeks I will post here what his recommendation is for me.

Read Wendell Reich's report of his bout with malaria and see how you feel about it -- of course he contracted a very virulent form, but he got the medivac treatment and it was a close thing. The other thing to consider is that if you do develop symptoms later, after your return, your doctor here may not recognize it.

Even if you take medication you may contract malaria, but at least for me I will take something.

Good luck with the specialist.

To add my ten cents worth, Deltaprim is very effective - especially if taken once every five days instead of every seven. It has FAR less side effects than malarone and definitely Lariam. Practical experience tells me that about 25% of people suffer nasty side effects from lariam, not 1 : 140 and especially those of smaller body weight.

You have a very good chance of not contracting malaria in Zim in August. For years I have safely not taken prophylaxis during the winter months.

Many of us now use the "no prophylaxis" and cure it with Coartem or Arinate these days. These drugs are safe, easy to use and very effective. A "time and a half" dose should be taken if you weigh more than 80kg/180lbs.

The VERY best form of prophylaxis is undoubtedly protection. Long trousers, socks, repellent at or before dusk and sleep under a net and /or with fans. current studies in Tanzania and Zim are proving this all the time. The female anopheles mosquito is really only present in numbers late in the evening (busiest 11pm to 2am). My wife has lived with me in the bush for nearly 20 years without chemical prophylaxis (she is sulfa allergic) yet has had malaria mildly only twice. She is religious about prevention.

Beware of the "experts" overseas as in that travel magazine. Quinine is now only used as a last resort. The artemesia drugs mentioned above now cure 99% of malaria. That magazine info is WAY dated. The Brits still cling to Chloroquin with Paludrine as a prophylaxis and it works quite well if you stick to it religiously. It involves paludrine daily and chloroquin weekly and I notice lots of people missing out pills etc. It is also a dated preventative. I would choose malarone before this, deltaprim before either.

Those above who recommended buying and carrying Coartem or Arinate have it dead on. The other thing to remember if you do contract malaria (yes incubation almost always 10 to 14 days) is to treat it IMMEDIATELY. I know many guys who have got VERY sick while the docs send away the blood tests etc. With the advent of artemesians we all treat ourselves at the first signs and are generally up and about within 2 to 3 days. Also rest when sick, if you push yourself/try to work or hunt you will get much worse.

I hope this helps, no science here, just 26 years of dealing with malaria in myself, staff, overseas visitors and my children.

Sorry, noticed I had not mentioned Doxycycline. It is very good for most people if taken correctly. The Aussies all use it and they have been dealing with malaria in PNG and other nice places their military go for decades. Its probably better than lariam or malarone, but i would still use deltaprim and try not to get bitten. It is an antibiotic after all.

Wolfgar, your wanting to temp fate by not taking prophylactic meds is extremely dangerous. Taking meds to cure malaria is by no means a sure thing. If stricken by P. falciparum type of malaria, even if ultimately cured, may leave you with chronic liver disorders, mental impairment, or kidney failure on dialysis. Malaria currently kills more people worldwide than ANY other infectious disease according to WHO. It can kill you even with proper treatment. REMEMBER: It is easier to prevent a fire than to put one out.

Geronimo