I think it is important to note that Malarone has the lowest occurance of side effects of any of the anti-malaria drugs.

I hate Larium. I tell my clients not to take it, try something else ... anything but Larium.

It is worth trying. I see no need to try the others when this one is the least likely to give you any problems.

If you have problems, fine, change it. But I recommend it as a first choice.

quote:

Originally posted by paul55:
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?

Paul, FWIW I've taken Doxy for about four years now for another medical condition. The only problem I've had was a bad sore throat a couple of years ago during flu season. Quit the Doxy for a while and took another antibiotic till things cleared up then back on the Doxy. YMMV but it's been good for me.

Rick

Since I have negative affects from Larium I don't take it. I took Deptaprim one year and came down with malaria about a month and a half after I got back. Not many Anopheles mossies in Idaho so I must have brought it back with me. Thrre other people in camp including one PH and one AP person also took Deltaprim and came down with malaria. I suspect we were dealing with a resistant strain in a communal land area where many of the natives also took it. Often incorrectly and the mosies developed a resistance to it. I'm no medico and just thinking out loud on that. I also believe that if you don't get bit you don't get malaria. Prevention is well worth the effort.

465H&H

JTHunt

Thanks for your informative answer regarding Deltaprim. I will be hunting in Chewore in the last half of May. Your post makes me feel safer in case I have to use Deltaprim. I always hunt with long sleeves and long trousers and will be sleeping under a mosquito net. However, all one needs is one sting...

I am aware that one can get malaria even taking prophylactics. What I do not know is what symptoms to look for for suspecting malaria, nor what types of tests there are for diagnosing it and the time it takes to do so. I live in Mexico and over here there used to be a lot of P. Vivax malaria (Paludismo) but today cases tend to be rare, so I do not know if the local doctors would know how to deal with P. Falciparum or weird resistant strains...

I am wondering if it is a good idea to get the Coartem you and Bwanamich mentioned just in case. Any idea how much they cost and whether they are available over the counter in Zim?

Antonio

Antonio, Coartem is definitely available in Zim - but I suspect via prescription. It should not be difficult, however, for your outfitter to get you some. Most doc's there help PH's get their medical chests together.

Malaria symptoms include high temperatures/fevers, shivering, aching joints and bones, bad headaches, nausea. The most telling are the fevers. At first it is very similar to a dose of influenza. There is often an ache in the lower back as the kidneys are affected.

Put it this way, if you suddenly are feverish, sweating then chilled and feel achy and terrible, AND you have been in a malarial area in the past few weeks, it is 95% malaria. It CAN also be tick bite fever which can be cured with a course of doxycycline. But if you feel that way and are not sure, take the coartem and 5 days x 200mg doxy.

Please remember this advice is borne of practical experience, I am not a doctor.

Sorry - I missed a couple of your queries. coartem and arinate (much the same drug) cost between $6 and $10 U.S. for a course in Tanzania. It may be a little more in Zim.

If you decide on deltaprim which is good stuff, take a tablet every 5 days, try not to get bitten (by mosquitos that is!) and most importantly continue to take the deltaprim for a month after returning home.

Good luck on your hunt, you will enjoy Chewore, it is real Africa.

Ditto what JTHunt says.

My wife has recently had a bad case of flu like virus. When it started developing, the symptoms were as described by JTHunt and as we had spent Easter at the coast, Malaria was suspected. She started a coartem course despite having a malaria test show up negative. (Myself and many friends have taken Coartem with no side affects or complications whatsoever despite not having malaria at the time - At the first suspicion of malaria type symptoms we start the dose!) I would hazard to say that it is not a problem taking Coartem treatment even if you do not have malaria!

Malaria blood tests in most places are NOT reliable! More often than one thinks, a malaria test will show negative several times despite the patient actually having it!

A good friend of mine that used to spend time with us in Kenya developed a bad case of malaria on his return home. He ended up in hospital. He was sure it was malaria and told the doctors where he had been, etc but they would not treat him for such unless they got a positive test result! He almost died before their umpteenth test showed a positive result for malaria and got treated just in time. It took him 3 months to fully recover from the ordeal.... Had he been in Kenya at the time, he wouldn't even have bothered going to see a doc. He would have popped the pills and taken a full course of the treatment (it was not coartem in those days)medicine and be done with it!

I've spent my entire life in malaria zones and other than when I was a toddler, never took prophylaxis except occasionally during the rainy season when mozzy activities is at its highest. Lost count the number of times i've had it!

To repeat what JTHunt said, i am not a doctor either but so far it has always worked for me ...and many, many others. Coartem in Tz is available at about $8 per dose without prescription. TOTALLY WORTHWHILE!

Deltaprim works if taken as directed.

I am alergic to it (sadly) so take doxycycline - which also works and prevents tick bite fever as a bonus- but plays hell with my guts.

Ganyana

If doxy gives you gut trouble, try taking a daily dose of (live) acidophilus (sp?) or if you can't get that, a daily live yoghurt.

you should be able to buy it from any good health food shop....... It'll also help avoid thrush which as I said in my previous post, can also be caused by Doxy.....

In 2004 I took Lariam while in the RSA and had no ill effects. Meanwhile, one of our guides was stricken with malaria (first time) after coming from a hunt in Zambia. He had not taken any anti-malarial medication because he was only going to be in Zambia for a short time (2 weeks), and he almost died in hospital. I am going back to RSA next year, and expect to take Lariam once more.
LLS

3 more days!

My question: I do have Doxy ready to start taking as a preventative measure. In another thread here, someone pointed out to me that I shouldn't need any preventative measure for where I'm going. If there's any doubt, I'll take the meds and play it safe. What do you all think about whether it's needed or not for where I'm going? We're headed to RSA, Limpopo area: www.shingani.com

From CDC website: South Africa: Risk in the low altitude areas of the Mpumalanga Province, Northern Province, and northeastern KwaZulu-Natal as far south as the Tugela (Thukela) River.

Since CDC mentions Northern Province, I thought I should take the meds to be safe. Am I worrying over nothing though if going to Limpopo?

This is last year's map, but it may be of some help (they don't seem to have this year's map).

Malaria Risk Map

Personally, when in doubt - I'd take the pills.

Regards,

Terry

I know a couple of people have commented on thrush, etc. w/use of doxy. Women should be even more aware of the side effects of taking that much of an antibiotic when it is not treating a present infection. Women are very susceptible to chronic yeast infections when using antibiotics in that manner. A yeast infection is not something I would want to have on safari! Not sure if this is true but I do have friends who say it is, but once you get a couple of yeast infections you tend to be prone to them - something else I would not want to bring on.

I'm sticking with Malarone.

Bumping this to the top to see if there is any new or updated info / drugs as it is about time to start sorting this out for this year's trip.

The University of Arizona has a travel clinic and they still recommend Larium as the single best med. Have had malaria and definitely DON'T want it again. Have taken Larium for 8 trips lasting up to 2+ months at a time with no ill effects. If I go again I will take it again.

While Doxy has the least possible side effects it is also the "least" effective as a prevenative for Malaria among everything out there. My Doc likened it to not much more effective than taking aspirin. I have taken Larium three times with no bad dreams, or other noticeable sides. Since you have to take it a week or two prior to leaving, try it, if it does produce negatives, you still have time to switch to something else.

Larry Sellers

i have used larium on 6 safaris , plus my 14 y.o. nephew took it when we went to Tz. after buffalo- never had a problem jerry dollar

also, doxy is a broad spectrum antibiotic primarily effective against bacteria- malaria is caused by a blood-borne parasite, not a bacterium. it will help prevent/treat malaria and tick fever but is not considered a drug of choice for prophylaxis

Another vote for Doxy here. It is about the best drug to have out in the bush as it is not only effective for malaria prophylaxis, but is also great for many tick/mosquito borne infections as well as normal soft tissue infections from wounds. It works perfectly fine to prevent malaria.

No more effective than aspirin? That is a load of crap coming from the doctors mouth. The thing to remember is know what strains of malaria are endemic to the area you are visiting and pick a prophylaxis based on the sensitivites to various drugs in YOUR area. Tailor the med to your risk. The CDC is usually a great source of info regarding this.

Wes

T.Carr:

I'll probably be accused of sucking up to the moderator - but your post needed saying - particularly for the benefit of first time hunters to a malaria zone of Africa. On my only trip I was 63 and took Lariam on the recommendation of a local (NY) woman doctor who specialized in tropical medicine and had worked in the African bush for years as a younger woman. I had no side effects whatever. As part of what is a private "campaign" of mine, I would like to add for the benefit of first time travelers in a malaria zone and I'm speaking only to you - Don't fool around with malaria. It ain't like Hollywood movies make it out to appear like - just a case of the tropical version of the flu. Its effects can sometimes be lifelong and very debilitating. You wouldn't fool around with hepatitis, would you? Malaria is worse. Consult a doctor who knows tropical medicine and follow the prescription faithfully. {Get your doctor to send your chart over to him/her. Malaria prophylaxis can affect heart action so anybody past 40 should not fool around with what lawyers call "curbstone opinions" -but should consult a real expert. Side effects? You can have these from ordinary aspirin. It's a calculated risk, of course, to take any medication - but personally speaking -having seen the effects of Panama malaria on my own father - I would risk "side effects" any time if the drug will cut down the chances of getting malaria or if contracted to reduce its severity. (That's all it can do. There is no vaccine nor cure all for malaria)

I picked up my two month supply of Malarone today after visiting my doctor. This will be my first time to take anything to prevent/reduce my chances of contracting malaria. I'll be in two different malaria areas in June/July so I'm glad I have it. I just hope the side effects aren't too bad.

My cost for 60 pills was $75, insurance picked up the rest. My doctor gave me two more refills on top of that since I travel so much to Africa. I also picked up a prescription for Ambien which will help with the jet lag and hopefully allow me to sleep through the night a bit better when I'm in the bush.

quote:

Originally posted by Bill C:
Larium was okay and no Malaria, but I did not like the minor mood changes (which has been documented as lack of "vigor") and the overall "funk" (fatigue), especially after the weekly does, which DOES indeed impact one's enjoyment AND effectiveness while on safari. Ditto for the month + after returning home. I think many people who say they experience "absolutely no side effects" (which was me the first time I used it) on Larium just don't pick up on it and/or have a basis for comparison, and attribute symptoms to jet lag, new food/sleeping patterns, etc. The thing with Larium is that it hits full capacity around the 2-3rd dose, so if you are taking it for the first time I read some good advise that suggests starting it 2-3 weeks early (versus the 1-week as prescribed for effectiveness) and this way you can switch if you note significant side-effects.

That pretty much matches my experience and I will be asking for Malarone next time.