The Accurate Reloading Forums
Malaria Prevention
18 May 2016, 00:35
MikeBurkeMalaria Prevention
I am headed to the Republic of Congo this year for three weeks. The CDC classifies the risk of malaria as high. As a comparison, Zimbabwe is listed as only a moderate risk.
I have used Malarone on seven trips (Tanzania, Mozambique, Zambia, Zimbabwe) with no side effects and never contracted malaria. I have no interest in trying Lariam.
Are there any advantages to using doxycycline? Would it have to used in conjunction with any other drug? Or is Malarone the best choice?
The CDC recommends either Malarone, Lariam, or doxycycline.
18 May 2016, 00:42
WV HitmanStay out of the sun with doxy. You'll get burned.
I've taken Larium for 8 trips. Never had a problem.
Larry Rogers
18 May 2016, 00:46
crbutlerMalarone is the standard.
Doxy works, and has the added benefit of suppressing tick borne illnesses of some sorts.
The down side is that if you use doxy, you are contributing to antibiotic resistance (all your gut bacteria will essentially be resistant to doxy at the end of the trip) and there is a risk of a photo toxic reaction to sunlight (read a bad sunburn with minimal levels of sun exposure.)
My recommendation is that if you can tolerate Malarone, use that. If not, then doxy. Lariam has a well known issue with causing hallucinations and is best avoided unless you have to use it.
18 May 2016, 00:49
David WMike, my advice would be to start Malarone a few days earlier than prescribed, before your trip. I used it as prescribed on a February hunt in Zimbabwe one year and contracted malaria anyway. I'm guessing, and my physician agreed, that I didn't have a sufficient dose onboard early in the hunt to protect me.
Anytime you're taking large doses of anti-biotic you should be taking probiotics as things like doxycycline will take out good guy bacteriia also !! Doxy is of course the standard for Lyme !
OT - those of us who have had a bad case of Lyme and have read the TIME magazine article about the fight against Zika virus are angered at the medical world ignoring LYME for years. Lyme has grown to be a huge problem because of this !
Mike, I used doxy on several trips and the sun sensitivity was brutal. You do not sunburn but your exposed skin feels like it is on fire. It was particularly an issue with my hands. I ended up having to wear gloves all day. After that I switched to Malarone and have never looked back.
Mike
18 May 2016, 01:38
DuckearAre there any advantages to using doxycycline? Historically the cheapest option. Also very safe. Sun sensitivity is variable and overall IMO, somewhat overblown. Folks that get burned tell you about it, those that didn't don't.
Would it have to used in conjunction with any other drug? Not for prophylactic use.
Or is Malarone the best choice? Depends. Overall it is shorter course. Take for a week after return vs 4 weeks for doxy.
Hunting: Exercising dominion over creation at 2800 fps.
18 May 2016, 01:43
boarkillerJust picked up Malarone on trip to Botswana next week
Always used Malarone, no problems
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18 May 2016, 02:29
Pondoroquote:
Always used Malarone, no problems
+1
18 May 2016, 02:56
1BigDeerWhat are the issues with these meds for those of us who would like a sundowner after the days hunt?
18 May 2016, 03:33
Use Enough GunThe directions that my Doctor has always given me is to start Malarone at home at least 3-5 days before I leave for Africa, and to continue to take it for about the same length of time upon returning. I have always followed that regimen.
18 May 2016, 03:51
Brandon.GleasonMike,
Thanks for bringing up this topic. I've started doing my research on what anti-malarial I'll use next Sept in SA. Malarone seems to be the front runner right now. I'm planning on talking to my PCP about it at my annual, and possibly seeking out the advice of a doc I used to work with in the ER that did an international medicine fellowship in central africa.
18 May 2016, 05:00
NakihunterInteresting info doc.
I am no expert and I used doxy on my one trip to Africa.
I found that doxy controlled a long standing (25 year) amoebic parasite infestation with the 2 week trip plus the continued medication on return. The damned cysts are very hard to get rid of and I am relieved that doxy had reduced the discomfort and flare ups. Getting the gut micoflora back in balance ws not hard.
Doxy is also great for controlling any secondary sinus & chest infection following dust allergy / hay fever.
quote:
Originally posted by crbutler:
Malarone is the standard.
Doxy works, and has the added benefit of suppressing tick borne illnesses of some sorts.
The down side is that if you use doxy, you are contributing to antibiotic resistance (all your gut bacteria will essentially be resistant to doxy at the end of the trip) and there is a risk of a photo toxic reaction to sunlight (read a bad sunburn with minimal levels of sun exposure.)
My recommendation is that if you can tolerate Malarone, use that. If not, then doxy. Lariam has a well known issue with causing hallucinations and is best avoided unless you have to use it.
"When the wind stops....start rowing. When the wind starts, get the sail up quick."
I always take doxycycline. I take it at night with my evening meal. If taken at night it reduces the sun sensitivity issue to almost non-existence. But I also always were long pants and sleeves. The back of my hands do get a little browner...but never burn.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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My wife and I were on Lariam for nearly two months without any problems.
DRSS
NRA Life Member
VDD-GNA
Mike,
We operate a large facility in Equatorial Guinea (on Bioko Island) where P. falciparum, the deadliest of the parasites, is prevalent (generally leads to death if not aggressively treated early). I would imagine it is prevalent in the Congo as well. The standard for years has been Malarone. We have expats who have lived on the island now for almost a decade, some accompanied by their wife, and they have taken Malarone the entire time (except when on leave in non-malaria areas). I've traveled to EG several times, and one of the worst areas for malaria is the marsh just outside our compound where several off-limit bars and establishments exist.
Of the very few cases I've heard of in our employees, every one involved an individual who quit taking Malarone as soon as the plane departed Malabo. It needs to be taken daily, and for 7 days after you leave the area.
I'm an engineer, not a MD, but Malarone is, I believe, a malaria treatment. You're taking the treatment daily, in the event you get infected, and you need to continue that treatment as if you did get infected the day you left.
I know too many people who have been successfully protected for years in one of the worst areas in Africa to try something else.
JEB Katy, TX
Already I was beginning to fall into the African way of thinking: That if
you properly respect what you are after, and shoot it cleanly and on
the animal's terrain, if you imprison in your mind all the wonder of the
day from sky to smell to breeze to flowers—then you have not merely
killed an animal. You have lent immortality to a beast you have killed
because you loved him and wanted him forever so that you could always
recapture the day - Robert Ruark
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18 May 2016, 07:24
Sean Russellquote:
Originally posted by ledvm:
I always take doxycycline. I take it at night with my evening meal. If taken at night it reduces the sun sensitivity issue to almost non-existence. But I also always were long pants and sleeves. The back of my hands do get a little browner...but never burn.
I have used Doxy several times--not only in Africa--as Lane says, take it at night . Never had an issue with sunburn.
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We have used Lariam for many years, and no side effects whatsoever.
In the past few years, we have been using Malaron.
Again, no side effects whatsoever.
Never tried Doxy.
18 May 2016, 07:44
JBoutfishnUsed Malarone, no side effects, and always enjoyed a sundowner or two without issue.
Jim "Bwana Umfundi"
NRA
18 May 2016, 07:54
shotgun46Me to
quote:
Originally posted by JBoutfishn:
Used Malarone, no side effects, and always enjoyed a sundowner or two without issue.
18 May 2016, 18:40
MikeBurkequote:
Originally posted by nhoro:
Mike,
We operate a large facility in Equatorial Guinea (on Bioko Island) where P. falciparum, the deadliest of the parasites, is prevalent (generally leads to death if not aggressively treated early). I would imagine it is prevalent in the Congo as well. The standard for years has been Malarone. We have expats who have lived on the island now for almost a decade, some accompanied by their wife, and they have taken Malarone the entire time (except when on leave in non-malaria areas). I've traveled to EG several times, and one of the worst areas for malaria is the marsh just outside our compound where several off-limit bars and establishments exist.
Of the very few cases I've heard of in our employees, every one involved an individual who quit taking Malarone as soon as the plane departed Malabo. It needs to be taken daily, and for 7 days after you leave the area.
I'm an engineer, not a MD, but Malarone is, I believe, a malaria treatment. You're taking the treatment daily, in the event you get infected, and you need to continue that treatment as if you did get infected the day you left.
I know too many people who have been successfully protected for years in one of the worst areas in Africa to try something else.
90% of the malaria species in Congo is P. falciparum, so there is a valid concern.
Malarone (ATOVAQUONE-PROGUANIL) is a treatment for malaria, but it is not recommended by the CDC to be used as a treatment if Malarone is used as a prophylaxis.
Thanks for all of the comments, they have been helpful in determining which prophylaxis to use.
18 May 2016, 19:41
butchloci had reactions to both lariam and malrone so i use cloroquin and doxy & it works fine. one advantage to the doxy is that you don't get tick fever while on it
18 May 2016, 20:07
1BigDeerMy Dr (travel/internal medicine) has prescribed Doxy and I feel that the additional benefit against tick borne illness is significant but does alcohol render the doxy ineffective?
18 May 2016, 20:21
sandyhunterIt can be good to pick up a package of Co-Arinate at the chemist while over there, just in case you come down with malaria after you get home. Co-Arinate is a three-dose treatment and usually beats malaria in a few days--much faster than any treatment you'll get back home, once the doctors finally agree that you have malaria. You'll find that your PH doesn't bother with prophylaxis and instead just keeps a pack of Co-Arinate on hand.
I have used doxy several times on trips to Africa and Central America and have never noticed any side effects (including sunburn.) Will be using it again next month when I go to Zim.
18 May 2016, 20:43
BuffHunter63Malarone always worked well for me. I have used cloroquin as well but it makes my stomach a little queasy.
I understand some people have weird experiences on Larium (which may or may not be fun).
If malarone works well for you, why change? JMO
BH63
Hunting buff is better than sex!
31 May 2016, 23:12
1BigDeerTo follow up this thread, I asked my travel Dr about whether the effectiveness of doxy is significantly reduced by alcohol consumption and he showed me a study that indicated little/no reduction from whiskey to the other end of the spectrum being red wine which had a 30% decrease in effectiveness. Good thing I drink whiskey!
01 June 2016, 00:03
shootawayWhen I visited the travel clinic to get a Malarone subscription the doctor saw in the records that I was once given a Doxy subscription.She asked me why and I told her it was what I asked for on my first trip.She said that it does nothing for malaria prevention and it is not prescribed for that.She said Malarone is the right one.
01 June 2016, 00:46
shakariIf you take Doxy, take it at night & also be VERY sure to take anti thrush cream in your first aid kit because if you need it, you'll need it VERY badly indeed!
01 June 2016, 00:59
Big Wonderful WyomingI took doxy for about 18 months worth of deployments to the Horn of Africa base Camp Lemonier Djibouti.
Worst nightmares you have ever had in your life. I drank a ton of booze while I was there (French Base is nice), don't recall a lot of problems with that.
Shootaway your Doc is partially right. Doxy keeps you from becoming symptomatic as it is easier on y our body than a long term use of Malarone or another drug.
You still have to take another antibiotic to kill the Malaria in your body when you return.
It is also signifigantly cheaper, that is why it is used by all military branches world wide for deployments to Africa and SE ASia.
Saying that Doxy works poorly, as I have had Malaria a couple of times using this regimen.
01 June 2016, 07:19
lavacaCan you even get Larium in the states these days?
01 June 2016, 08:15
D. NelsonMefloquine aka Larium.. Just got my prescription!!!
Used it for all my safaris and aside from vivid dreams no negative affects at all. Okay now I'm thinking it caused a hunting addiction! But that's not negative!
Best regards, D. Nelson
01 June 2016, 08:31
MJinesI took Larium in connection with several business trips to India. I will never take Larium again. For weeks after taking it I suffered from bouts of serious depression. Only later did I learn about the many problems military personnel had that had been taking Larium, with suicides, homicides and other problems. Buzz also tells the story of a client whose wife was taking Larium and went absolutely bonkers in camp, hallucinations, paranoia, etc. . . . to the point of having to be sedated and medivaced out of camp. I think I would rather take my chances with malaria than take Larium again.
Mike
01 June 2016, 08:33
Frostbitquote:
Originally posted by D. Nelson:
Mefloquine aka Larium.. Just got my prescription!!!
Used it for all my safaris and aside from vivid dreams no negative affects at all. Okay now I'm thinking it caused a hunting addiction! But that's not negative!
Best regards, D. Nelson
Please switch to Malarone. We love you.
J&J
01 June 2016, 18:35
D. Nelsonquote:
Originally posted by Frostbit:
quote:
Originally posted by D. Nelson:
Mefloquine aka Larium.. Just got my prescription!!!
Used it for all my safaris and aside from vivid dreams no negative affects at all. Okay now I'm thinking it caused a hunting addiction! But that's not negative!
Best regards, D. Nelson
Please switch to Malarone. We love you.
J&J
Thank you!
01 June 2016, 19:40
Global_RescueDr. Phil Seidenberg, who spent five years living and working in Zambia as Global Rescue’s African Regional Medical Director, has treated many malaria patients in the course of his career. Dr. Seidenberg points out that significant global progress has been made with malaria over the past decade, with better control of malaria and fewer deaths from malaria for multiple reasons. We spoke with Dr. Seidenberg and posed five common questions that travelers may have about the risks, prevention and treatment of malaria.
How to Prevent and Treat Malaria03 June 2016, 02:38
JohnDLIf anyone intends to use doxycycline as their primary prophylactic I would strongly recommend trying it before going on safari (with sun exposure). As was properly pointed out earlier, the sunburn it causes is not the usual type, but is absolutely debilitating. A few years back I had to give doxy to an appy PH and his safari ended at that point---he had to stay in his tent until he finished the course. Make sure you aren't sensitive before going on safari.
BTW, one should never say never. I had used lariam for years without problem, as had my hunting partner. We stayed in a hotel before flying out to the camp the next morning. We split a bottle of red wine and both had very wild, bizarre dreams (bordering on hallucinogenic). Most unpleasant. Needless to say, neither of us had wine for the rest of the safari (21dd) and did just fine.
03 June 2016, 07:01
lavacaWatch for effects of drug interaction when you add an anti-malarial. For example, one potential side-effect of Malarone is stomach upset. That is also a side effect of Allopurinol, a daily medication that I take to prevent gout. I learned the hard way that you don't want to take them both in the morning, but you can take both in the evening before you go to bed and it all works out, or one in the morning and one at night and all is well with the world.