Malaria
 

We are leaving for our first safari to Kenya on the 26th of this month. We have gotten all the required immunizations and am about ready to get the prescription filled for Malaria. (Mefloquine) I did a little research online, and am now scared to death to take this medication. Has anyone had any adverse effects, and is it absolutely necessary to take it when travelling to Kenya.

another option with less side effects is Malarone. every one has an opinion on the two but the consensus favors Malarone over Larium (mefloquine)

Wife and I used Malarone in 2003 and 2004 with no side effects.

we also used malarone in October and no side effects either.

An alternative. I have used is Doxycycline. In Asia, Africa and South America and never a problem. Its cheaper too.

I've taken Mefloquine many times with no problem. Wouldn't know it was in my system. If your doctor/travel clinic prescribed malaria medication, I'd take some form of it.

My travel doc prescribed doxycycline as well. I'm not sure if that's because my health plan covers it and I would have had to pay for Malarone, but we took doxy with no side effects other than increased sun sensitivity. I understand that it is the least effective, however. (?)

So, you do have some options.

Enjoy your safari. I'm sure it will be wonderful.

Hello,

Malaria prophylaxis is definitely necessary when travelling in Kenya. Regardless of how unpleasant the drug is, it is much less unpleasant than contracting malaria and having to be evacuated, like one Fodorite's father.

If you are concerned about the medication, you have two options. You can opt for Malarone, which has the lowest incidence of side effects, but is quite expensive (about $1 per pill in the US, I believe).

Alternatively, do a drug trial with Mefloquine -- take it for a few days and see what happens. If you are side-effect free, you can stick with it; if the side effects bother you, you can get Malarone. You should start the trial soon, as most doctors advise trying it out for about a week before making the decision.

Cheers,
Julian

Hello Stvmic,

Do as Julian says. He’s a doctor. I’d recommend his second alternative, unless you have money burning a hole in your pocket.

Many people get side effects when taking Lariam (Mefloquine), but most don’t. I used it in 2004 and 2005 and will continue using it until something better and cheaper appears.

Lariam (mefloquine) costs about $9-$10/pill which you commence taking 1 or 2 weeks prior departure (same day weekly), weekly while in Africa and then for 4 weeks upon your return. Assuming a 2-week safari, you'd need about 8 tabs costing about $90.

Malarone which has less side-effects, is taken daily, commencing 2-days prior arriving in infected area, then daily (preferrably in the morning with food - dairy such as milk, yougurt, cheese is recommended). And for 7-days upon returning from the area. If you have a drug plan these pills may cost about $35+/-; without a plan, figure between $90-$120, so check around.

Doxycycline, is an antibiotic (and a generic med) and not specific for malaria but often recommended for those who for some reason can't take the other two. These tend to make one sensitive to sun and woman may get thrush (yeast infections). Though less costly than those above, have to be taken for 30-days after leaving/returning from infected area.

Though some people have no reaction to the Lariam, the possible side-effects can be restless or interrupted sleep, wierd dreams, even psychotic episodes. Fewer people have reactions to Malarone, if any. With doxy you have to consider the side effects as above.

Discuss again with your physician.

In Sweden 8 Lariam pills cost about $ 28, and that’s paying full price. I´ve paid a lot less for left over pills from a person I found on the Internet.

Here's a good article published by the Center for Disease Control about the drugs, their side effects, who should not take each one, etc.

http://www.cdc.gov/travel/malariadrugs.htm

Jack -

Great summary. Thanks.

I take Palodrine and Chloroquine. The doctor says "you should take Lariium" and I say that I wont take it because of the side effects (For me it's disturbed sleep and bad dreams.. for others it seems to trigger quite serious psycological illness.

P&Q works for me, but it's not the most effective. Malarone I've not tried.

My advice would be to take the advice of a Tropical Diseases specialist. Fortunately in the UK we have a Tropical Diseases hospital in Liverpool, and I have a friend who did her specialty there.

I, as well as several of my friends, have taken Lariam several times with no adverse effects. In fact, I do not personally know anyone who has had a problem with it, in spite of all negative things I have read it.

For my 15 January safari to Tanzania I will be taking the generic mefloquine which was considerably cheaper than the name brand and cost me about $1 a pill.

Leann

There is good thread about larium pros and cons, somewhere.
I think everyone should take what's best for them, but after reading some articles and having my doc. tell me that the possible dream side effects seem so real and vivid that I chose to take the Malorone.
My Nigerian travel doc. told me about his friend who woke up with snakes biting him whilst running around camp in his undies.
I know not everyone will experience this, but having to worry about which undies to wear to bed would be just one more extra inconvenience for me.
Sherry

Just took my first Larium this morning, and I'm perfectly fine, aahh! whats that behind me.....

And I do expect that you have good undies on Napa, just incase - ha.
I should have inferred in my last post that I was joking - to save me from getting razzed from you fine folks.
Sherry

Sherry, smileys and whatnot are goofy, but helpful for conveying the "I'm just kidding" vibe.

I remember reading about Larium and the term "vivid dreams" kept coming up. I'm pretty sure I don't want my dreams any more vidid than they are already. ;)

Hi
about MALARIA
First of all there is no 100% prevention – the Plasmodium spp mutate & evolve new strains appear’ & this is why new medications appear
Though looking again at data some claim it’s 98% !!

Let me summarize :

1) Chloroquine & Paludrine (proguanil)
Paludrine was added to classic Chloroquine to extend the coverage of the drug
(blocks an enzyme which has to do with reproduction of the parasite)
The problem: Paludrine needs to b taken daily, this is why Mefloquin became popular – only once a week

2) Mefloquine (“Lariam”) – taken only once a week it was considered more convenient than 1. It does have more side affects than the others, the most scaring, though rare, r psychiatric ( someone with psychiatric background should never take it
look at this site references:
One source: 0.7% (1 in 140) travellers taking mefloquine can expect to have a neuropsychiatric adverse event
Another:.” Neuropsychiatric adverse events were found in 29% of the subjects, with 19% being considered "moderate or severe". http://www.indiana.edu/~primate/lariam.html


3) Doxycycline is actually an anti-biotics which was usually prescribed for those who were reacting badly to Mefloquin or to persons with a certain medical record …
Much less side-effects than Mefloquin


4) Mallarone a new drug containing also proguanil (like in Paludrine) but is taken once a week & has less side-effects than Mefloquine …

Conclusions: a) The best is to consult a doctor b) if he says Mefloquin he is in a serious minority among world specialists … c) why take chances – there r alternatives

Aby
PS as for myself’ since staying long periods in safari country (though I did get malaria in the early 1980s) I couldn’t ruin my liver with long term medication.
In some of these areas, higher altitude & certain seasons there is no malaria,
But I do not want to specify. TAKE PILLS & use other methods of protection.

just to b more precise:
in certain altitudes & seasons chances r small !

Aby - Malarone is taken daily, not weekly. (Just wanted to correct this info for those searching the topic).

Apologies if I'm repeating previous posts, I have only skim read.

Firstly, do not underestimate the importance of antimalarial medication. My father is a keen traveller and now that he's retired, is often away once a month to all kinds of destinations. I think because he was travelling so often he decided not to bother with antimalarials.

He was hospitalised with a really severe case not too long ago - they have no idea on which of his trips he picked it up as it can take months for symptoms to manifest. It was not pleasant and I was shocked that, even after diagnosis, there was a real chance he might not make it. Glad to say he did. After the initial scary hospitalisation he made a swift and full recovery and has since been to India and is about to go to Costa Rica, a destination he's previously enjoyed. He's definitely not taking any further chances and is certainly taking antimalarials for all future trips where applicable.

Secondly, you cannot make a decision on which antimalarial to take based solely on statistics about efficacy or side-effects as it depends very strongly on where you are travelling. Different regions host different strains of malaria and these react differently to the various antimalarial regimes. In some regions the most commonly encountered strains have developed a level of immunity against some of the prophylactics so these are not advised unless all others are unsuitable for medical reasons.

Anyway, best of luck and have a wonderful trip!

Thanx schlegal1 !
Indeed i made a mistake !!
sorry (late night...)

Hi,
Have read a lot of the past comments regarding anti malarial tablets etc. I am kind of put off by reactions etc. Has anyone heard of or used a homeopathic remedy called Demal 200. More info on the website of www.blueturtlegroup.com. I would be interested if anyone has any info on this it can be used as a prophylic as well as treating acute cases of malaria. Also I am currently looking at the Avon skin so soft insect repellants and sunscreen combined - any feedback on them would be great. We are only going to Mombassa Shanzu beach area beginning April. Anyone stayed at the Serena Beach Hotal there? Thankyou

>We are only going to Mombassa Shanzu >beach area beginning April. Anyone >stayed at the Serena Beach Hotal >there? Thankyou

Yes, Serena is second home in Kenya. Love it. If you want any info on the Hotel please drop me an email. If you watch your Hotel TV there you will see some of my underwater photos taken there. Great diving... and a very good diving school.

The likelihood of being bitten by mossies at any of the coastal areas is higher than if inland. These areas are hot and humid and April being one of the wet season months, even more likely that mossies will be flying about.

Can't comment on any other than those meds specfic for malaria - i.e, Lariam, Malarone or doxycyline - but some people just can't take these, or choose not too. However, malaria is a nasty disease, and even the specific meds aren't an inoculation. All are preventatives only. So you have to be certain to follow the other requirements of being covered - long sleeves, pants and socks - from dusk to dawn, when these critters bite. And repellent should be used on all exposed skin.

I've used the Avon product when inland and since there weren't many mossies, I can only guess that it worked for what it's worth. Don't know how effective, if at all, this product would be on the coastal areas.

You have to discuss your options with your own physician and make the decision that you feel is best suited in your particular circumstance.

:) it's funny - I have posted same questions a few months ago. stvmic, my husband and I had same kind of fears you do about Lariam. However, we took it (and still are taking it), and didn't have sideaffects. I would recommend split each tablet into 2 parts and take them within 6 hours of each other. That should bring sickness, haad-ackes, nightmares, etc. to the minimum. Don't concentrate on it too much, and you'll feel just fine!

Simplest thing to do with Mefloquine is to start taking it a couple of weeks before your trip & if you have any serious problems STOP and take something else instead

Do all these drugs require a prescription? I am sure they do here in the U.S. and I have not checked to see what my Dr would recommend or our insurance will cover. But we will be stopping over in Amsterdam en route to S. Africa. Are these drugs available in pharmacies there? Thanks :)

I was in zambia last summer and am returning to zambia and zanzibar this summer (June-Sept) to do missions work. I took Malarone last time but it made me nauseous. I was thinking of taking larium this time since some friends haven't had any problems with them and I also wouldn't have to worry about taking them every day. Any opinoins or advice?
Laura

I cant give you personal details on Larium or Malarone but I have read alot about them. All I would say is that we have taken the decision as a family of 4 going for two weeks to Shanzu beach to take Demal 200 a homeopathic spray which can be used for long term as well as short term and has very favourable feedback from travellers who have used it. I will be able to comment further after April on return and give some feedback. There is a website with further info on this product which is quite extensive. the guestbook makes good reading too. Upon reading personal quotes and reading about each product my view is we will all react differently to each of them and it will be trial and error which is the best for you.

I have recently been to the Drs for injections and was advised for our family to take Malarone. it is the most expensive of these drugs and would work out I believe for all 4 of us £200.00. Yes you do need a prescription here in the UK for anti malarial drugs and at our Drs the prescription has to be a private one and therefore it has to be paid for and not given via the National Health system. Maybe different countries have their own rules but I understand here in the UK it can only be given via prescription.
thanks

Malarone, Lariam and doxy are by script only in the States as well. Doxy is the least expensive, but has to be taken for the longest amount of time. Larium is now available as a generic, but isn't much less expensive than the band name. Malarone is only available as a brand name and the most expensive, running about $100+/- for about 23 tabs (covering a a two wk vacation - pre-tabs and post-tabs).

Many of the health plans that include drugs, charge a reduced price, depending on the plan. Otherwise, you have to pay retail.

When planning a trip anywhere, especially to exotic destinations, one should check on visa, inoculation and other med requirements before the land arrangement. Too many people are suprised by the additional expenses that can run a few hundred dollars per person... and all after they've negotiated the best deal for the land itinerary. It's a good idea to heck about the incidentals beforehand.

carolm123 - Save your money. Buy a good mosquito repellent. Your Demal 200 (and all such homeopathics) is worthless against the microbes which cause malaria. The most you can hope for is that it keeps the mosquitoes away.

Water would give as favorable a reported result as Demal 200. Most people will not be bitten by a mosquito carrying active malarial material, but if you're unlucky enough to be one of them - you will wish you had a real solution.

What is the malaria risk in Namibia for travel in October to the popular safari destinations like Etosha? Those of you who travel repeatedly to Namibia, do you always take malaria medication?