My sister and I are going to South Africa in late September, and are in a quandry about which malaria meds to take. At first, Malarone seemed like the best choice, until I searched for user reviews and found many people had serious side effects. Now, I'm considering Doxycycline instead. We are only going to be in a malaria zone (Sabi Sands/Kruger) for 3 days , at the end of the 2 weeks trip. Another option is to be covered in insect-shield clothing and Deet, as well as one of those new Buzz-off clip ons. Has anyone skipped the meds and contracted malaria?
How about side effects with Malarone or doxycycline?
I have been taking Biaxin for a couple years, for chronic lung problems and worry about drug interractions.
Thanks for sharing any knowledge or experiences.

I have used both Malarone and doxy with no problems. I have not used/tried Lariam/Mefloquine.

regards - tom

I asked an infectious disease doctor about this and he said either Malarone or doxy are fine. They have different side effects. Doxy much cheaper, he said.

I've used malarone exclusively on trips to Africa and never experienced any side effects. I steered away from lariam because I'd heard others report on some nasty side effects, particularly psychiatric ones.

Malarone is usually started 1-2 days before entering the malarious area and for 7 days after leaving the area. I believe doxycycline is normally started 1-2 before entering the malarious area and for about 30 days after leaving the area. The extra days on meds are something to think about.

You're rightfully concerned about drug interactions and you ought to discuss the entire matter with your doctor.

Best of luck---I know you'll love South Africa and the Sabi Sand/Kruger region. Steve

Hi annereilly

Without doubt go and see a travel doctor. It really is a specialist area of what you should be on, and beyond the knowledge of most general practitioners. I am on other drugs as well, and can only take doxycycline and have never had any issue with them.

Don't take medical advice from any of us, as you will be the one to pay the price if something goes wrong.

Kind regards

Kaye

But the one piece of "medical advice" from this forum that would be sound, is "take some kind of suitable prophylaxis".

Whether 3 days or 30, it takes just one bite.

For general info including the "Malaria Risk Map", this site with input from the Medical Research Council of South Africa, is useful: www.malaria.org.za/Malaria_Risk/index.html. Near the bottom of that page are links to .pdf docs from the S.A. Department of Health.

Doxy, like Biaxin is an antibiotic. Only your doc can advise whether it's a good idea to be taking two of these.

As above, Doxy has to be taken for 28/days after leaving infected area, can cause sun sensitivity (needing to use SPF on any exposed skin) and for women the possibility of "thrush"(discharge) - something I'd prefer not to deal with while on holiday.

Any med, even aspirin can cause side-effects. Over the years, I have taken Lariam and Malarone and not a side-effect from either. Use the new Malarone these days, regardless the higher cost.

Remember, malaria is a nasty disease and all you need is one mossie bite. Even for a few days in a malaria area, I wouldn't chance it.

We have taken Malarone for many trips. We have only heard of 1 person who had problems with it, in all our travels. Malarone has been improved, so side efffects are minimal if any. DO NOT go with out anything. As the OP above said Malaria is a nasty disease. I have seen it once and that was enough.

Out of 9 people taking Malarone on one of our safaris, 2 developed serious side-effects from it (nausea & dizziness, mostly.) It took several days for those side-effects to develop, though, so you might be done with your trip, should you be unfortunate enough to have the same happen to you. Any malaria prophylactic can have side effects and Malarone is supposed to be the safest.

I've never taken doxy, but had Lariam on our 1st safari with bad bad side effects. Subsequent safaris were with Malarone with no side effects whatsoever.

The travel doctor will know best. But you will still need to be smart about using repellant anyway.

We have taken Malarone on many trips and the only side effect we had were "strange dreams". Nothing else.

Doxy lead to serious side effects (in Germany Doxy is niot allowed to be prescribed as a prophylaxis; it's a antibiotic) being the skin extremely sensitive to sunrays.

Doxy should only be taken by people who have dark eyes, hair and olive skin.

When travelling in the dry season we now only use bug spray. Zambia, Botswana in October - no medication.
India in June - no medication.

We covered our arms and legs, applied bug spray. Fine.

Don't think because you swallow tablets keeps you safe! You still have to use other precautions!

Having taken Malarone or similar drugs and you feel flu like symptoms: Tell your doctor you visited a malaria area and let your blood check!

Happy Travels!

SV

I came across the abstract below which provides at least two very interesting bits of information for visitors to Sabi Sand/Kruger: malaria risk assessments are based on incidences in local communities (meaning, I believe, that long-term antimalarial drug use is unlikely) and that only 4.5 cases in 10,000 visitors (a low percentage) were observed in April (high season for malaria).

It would be reassuring to see additional studies that support these results. Nevertheless, the abstract suggests that prophylaxis plus some additional care (long pants and sleeves at dawn and evening, along with some repellent spraying of the ankles) makes the malaria risk very low, especially during the low season.

http://www.cababstractsplus.org/abst...No=19991800738

That is an interesting abstract. I'm going to try to get access to the entire article. I would also think that the risk of contracting malaria within the park is higher than the risk in the private reserves, as there are are more people working inside the park.

This abstract is consistent with my observations of the number of mosquitoes in Kruger. I've visited twice (April and August) and have seen less than 10 mosquitoes over a cumulative period of 2 weeks.

One should still take appropriate prophylaxis while visiting. Personally, I would forego purchasing specially treated clothing and just buy mosquito spray while there.

I've used both Maralone and doxycycline without too many problems. I've used doxy the most--make sure you wear sunscreen if you take it. Also, follow all of the directions for taking it. Don't take just before bedtime--you will likely end up with a very nasty case of acid reflux like I did.