I've done 12 safaris and on every one, I have taken Malarone, no issues. I leave in about 10 days and a person going with me said his doctor told him Malarone was less effective in Zimbabwe than prior. Dr. Recommended Doxycycline. First I've ever heard of this. Anyone else or are all using Malarone. Thanks for comments

Lately they are recommending doxi instead malarone...who knows real reason for that...
I can tell you doxi is a bit problemátic with sun...
If I were you I will continue with malarone but maybe wiser to follow doctor advice

Best regards

Used Malarone each trip to Africa - hunting and non-hunting plus India. I also take Doxy with me. I use hydroxychloroquine for South America.

If you plan on sitting in the back of the truck for long rides, stay away from Doxi! the sun sensitivity issue is real.

Still using Malarone... I'll be in Moyowosi in late September and plan on using it again. Need to update some shots though. Think my Yellow Fever is timed out.

quote:

Originally posted by bwanamrm:
Still using Malarone... I'll be in Moyowosi in late September and plan on using it again. Need to update some shots though. Think my Yellow Fever is timed out.

When was your last YF? When I got my Stamaril when YF-Vax was temporarily out of production I was told it was good for life.

Starting my Malorone tonight.

For many many years, we used the weekly one, cannot remember its name.

Supposed to have bad side effects as hallucinations etc.

Never had any of this, non of us, which in total must have been dozens of people.

After that our doctor recommended Malarone.

Again, we have been taking it for many years.

No side effects and it worked.

I think Malarone you take a couple of days before travel??

Lariam was known for playing havoc with the psyche..some went rather crazy..

I never used it..I used Malarone on several trips to Botswana..no nasty side effects.

However, a friend of mine used Malarone in Zim, he had bad dreams etc.

I have heard of stories where hunters have cut down their hunts because of the bad side effects??!!

I mostly used doxycycline

Larium sent me troppo- never again!

Malarone was ok but expensive. I never had sun sensitivity with doxy plus it is good for tick fever and many other ills.

I've used malarone out of fear of side effects from larium. My first trip in 2017, I had some anxiety/nightmare issues the first night. I didn't have any recurrence of that in 2021 or 2023. I'm planning to take malarone again for Zambia this year.

I'm not seeing any publications on malarone resistance.

I tried Malarone once for a trip to Zim. I couldn't sleep while on that drug. Never used it again. I use Doxy and take it as soon as the hunting is over for the day. Never had any problems with sun sensitivity but I do use suntan lotion.

Funny enough, we can buy Larium off any pharmacy with no prescription.

Malarone we have to get through a doctor??!!

If an American doctor told me some news about Malarone, I’d ask him where he heard it. His answer would probably surprise you. Read it in a magazine? Saw it on the Internet?

I guarantee it’s not because he’s seen numerous cases of malaria from Zim. American doctors, even infectious disease docs, see a very small handful of cases over their entire career. Most will never see a case from Zimbabwe.

I’d take the Malarone over doxy.

I think the need depends on where you are, If I hunt Zim it is typically in the lowveldt (S/SW). I have never taken an anti malarial and never had an issue. Might do it different if I was in the Zambezi. Ask your PH to get you some Deltaprim, it's one pill a week and I believe you can start taking it upon arrival? None of the side effects of Malerone or Doxy

I've had malaria loads of times and taken most of the "stuff" out there. Here's my take FWIW:-

- Chloroquin (Malarone I think??) - not very effective and I'm sure its given me tinitis after taking for years (nothing to do with thousands of shots from centrefire rifles....).
- Lariam - works but definately has effects even when you feel OK - I was on recovery from a bout and went for a blood check ten days out, felt perfectly OK - little buggers were still there, so I was given a strong dose of Lariam (3x500g, 2x500g, 1x500g) and went back to work. Nothing happening up there - still felt OK but just couldn't do anything.
Halfan - off the market now but worked for me - saved my life in the Massai Steppe. I know very well it has killed people I know.
Doxycycline - brilliant - no downside I can see.

As said I am always very doubtful of any advice in this area given by a non-African doctor. Can you imagine any US or European doctor taking blood, prepping a slide, examining and telling you there and then what the situation is? Over here (Scotland) if you had malaria you'd be dead before the test results came back.

My wife is heat sensitive. We both took doxy on our 2012 Zim safari. In spite of sunscreen and long sleeved shirts she developed a rash and had to stop taking it. On our Uganda trip this year we both took Malarone, and I had weird dreams and night sweats, but no other side effects. While waiting in the airport for our flight home I had a conversation with another group that had similar issues. It still beats getting malaria, especially when very few U.S. doctors ever see a case.

Malaria vaccine is now available and it reduces hospitalisation by 30%.

One version was developed in India. Approved by US now.

Safe for INFANTS BELOW 2 YEARS!

Take the doxy at night. Sun sensitivity is greatly reduced.

Have taken Doxi on 3 trips with no sun problems I do take a probiotic

quote:

Originally posted by Kuwinda:
I've had malaria loads of times and taken most of the "stuff" out there. Here's my take FWIW:-

- Chloroquin (Malarone I think??) - not very effective and I'm sure its given me tinitis after taking for years (nothing to do with thousands of shots from centrefire rifles....).
- Lariam - works but definately has effects even when you feel OK - I was on recovery from a bout and went for a blood check ten days out, felt perfectly OK - little buggers were still there, so I was given a strong dose of Lariam (3x500g, 2x500g, 1x500g) and went back to work. Nothing happening up there - still felt OK but just couldn't do anything.
Halfan - off the market now but worked for me - saved my life in the Massai Steppe. I know very well it has killed people I know.
Doxycycline - brilliant - no downside I can see.

As said I am always very doubtful of any advice in this area given by a non-African doctor. Can you imagine any US or European doctor taking blood, prepping a slide, examining and telling you there and then what the situation is? Over here (Scotland) if you had malaria you'd be dead before the test results came back.

from a frozen north to another frozen part of the north here is some extra information.

4 medications mainly exists:

chloroquine under many names depending of the countries
mefloquine or lariam
Doxycycline
Atovaquone-proguanil (or Malarone)

when i lived in the end of the 80s in CAR chloroquine and derivates were the only one accepted if you lived on long run as lariam had effects unknown on the long run and stay but as of today chloroquine is not as efficient as it was and the cumbersome was taking a pill a day and you can forget ... at the time it was the advice given to us from institut pasteur doctors.


today some areas have developped resistance to chloroquine and/or mefloquine.

another drug the Primaquine can be used but that one is a little more complicated and side effects can kill ...

hope this is more clear.

A doctor recently recommended doxycycline to me vs. Malarone for malaria because doxy also works against tick borne illnesses.

But I have stuck with Malarone as my anti-malarial for nearly thirty years.

I have also brought along doxy to use in case of tick bites only. I don’t like the sun sensitivity side effect of doxy.

Doxy apparently one needs to take for 28 days after the hunt!!??

quote:

When was your last YF? When I got my Stamaril when YF-Vax was temporarily out of production I was told it was good for life.

12 years ago. I understood they were good for 10 years. I've had two...

Took malarone with zero side effects.

I did bring a full round of Doxy with me. But that was more if bitten by tick borne illnesses. But never used it. Have heard it's rough if too exposed to sunshine and burning.

Just back from the Zambesi. Still taking the malarone.It has worked for me for many years. Big outbreak of malaria in Zimbabwe right now. Repeat doses of Yellow fever no longer considered necessary. Lasts a lifetime.

Doxy is so useful for many other illnesses like Q fever etc.

There was a class action in the USA against military for the effects of Larium. Not sure where it ended up. I know the Military School of Tropical Medicine in Australia trialled it but cut the trial short due to the side effects.

Primaquine is a treatment I believe, not a prophylactic and you need some blood tests to see if it will kill you or not.

When I lived in Tanzania I used to carry a couple of five pack malaria test kits, first sign of sickness that is the first thing you did. Also carried the treatment. Test kit would indicate which type of malaria. Didn’t see these test kits when working in Borneo. Me, I suffered from dengue and was fortunate to never get malaria. But nearly kicked it from typhoid in Mexico.

I've relied on malarone for over 15 years, both on safari and for business (West Africa). Not a doctor, but on the business side, it was the prefered medication, but doxycycline was an accepted alternative.

I was an occasional vistitor to the area of operation, but I know many expats who spent over a decade as residents and took malerone daily with no apparent side effects or incidents of malaria (this is in the equitorial region where P. falciparum is the norm, which for westerners can easily equate to death if not treated aggressively).

Malarone treats the infection I believe, vs preventing it, so you start it 2 days before arrival so its in your system and continue it 7 full days after departure. The handful of cases we did have in West Africa all involved the same set of circumstances. Flights out were either Air France or Lufthansa, both in the evenings after dark, and the departing people left in shorts or not fully covered resulting in bite(s) before boarding. Unfortunetly the airport, and our compound, was one of the worst areas for both mosquitos and malaria. The infected people then ceased taking the medication upon departure.

The problem then becomes western doctors, or any doctors not accustomed to malaria, often fail to consider it a possibilty when someone shows up ill and then declines quickly from there ....

If malarone has in fact become "less effective" in Zimbabwe (which is where most of my safaris have been), then either the manufacturer has changed something, or the malaria strain in Zim has mutated and become resistent to atovaquone and proguanil.

Or ... the postive cases have been improper use of malarone ....

quote:

Originally posted by BigBBear: I leave in about 10 days and a person going with me said his doctor told him Malarone was less effective in Zimbabwe than prior.

Please check your PMs.

I have never used malarone but have used doxycycline many times over the years, at least once per year for over a decade now.
I have never experienced any negative side-effects except once when the med came in the form of a capsule as opposed to a tablet. In capsule form I had some pretty significant GI issues which really interfered with a family trip in Costa Rica. I checked with my travel PA when I got home and told her about it. She then checked with a pharmacist who said that indeed some folks do have GI issues with doxy in capsule form. I have since used it in tablet form with absolutely no issues at all, including sun exposure.

My biggest concern with using doxy for prophylaxis is that using it for long periods of time can cause antibiotic resistance and it is one of the better drugs out there for lots of things. The fact that it works for tick fever, etc. is actually a reason to save its use for illness instead of prophylaxis… and yes, the biggest use in the US is for … acne. Go figure.


The CDC is saying they are seeing increased resistance to malarone in some of the southern African nations… whether it is making malarone less effective than some of the others, I don’t know. I haven’t seen formal guidance to stop using it, but the note of resistance is worrisome.

Chloroquine is noted to have high resistance in most areas of Africa.

Larium is pretty fraught with psych side effects. That being said, it is usually how we treat active malaria in the US, albeit at higher doses than used for prophylaxis.

The malaria vaccine is not available in the US. What I have seen is they are targeting kids in endemic areas. Supposedly it’s a 4 dose series.

While 30% effectiveness is better than nothing, I’m not holding my breath that with that level of effect that it will become standard here, those are not encouraging stats.

I personally use the malarone. I think it’s the least problematic and most effective option for prophylaxis.

As to yellow fever vaccine, they changed it to once in a lifetime.

I’m not sure if their rationale was proof of lifelong effect, or if the fact that it (rarely) kills folks made the risk/benefit curve skew so that the additional effect of boosters was overwhelmed by risks.

The CDC is usually very good with statistics and that’s what vaccine programs are at their root- risk of prevention of bad outcomes vs risk of the vaccine side effects.

Just received doses for 8 people for 21 days from my Doctor.

Malarone, as recommended by him.