Sandi - Malaria Question

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Apr 6th, 2004, 11:15 AM
  #1
SoBeTraveller
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Sandi - Malaria Question

You seem to keep up with the latest. Our travel health professional has said we do NOT need meds for malaria when we go to Botswana before spring (November). Does this square with what you've heard? I checked CDC and their website wasn't definitive.
 
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Apr 6th, 2004, 12:21 PM
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sandi
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SoBeTraveller - November is, in fact, like May in the Northern Hemisphere - so closer to coming on the end of Spring. I accessed the CDC site right before responding here and it clearly states that Chobe and the Delta areas are Malaria zones. And based on the amount of water they've had this year and the fact that in November it is getting Hot and is Humid - I'd most definitely take precautions.

It is called "being safer than sorry". The new Malarone has little, if any side-effects (as compared to those of the formerly recommended Lariam). While the CDC site lists some common reactions, I haven't yet come across anyone who has taken the meds with food, daily, having any reactions whatsoever.

Realize that there is no inoculation for Malaria, and any of the current malaria drugs aren't a guarantee of not getting malaria, but the Malarone has been proven 90+% effective. And along with using insect repellent containing Deet during mossie biting time - dusk to dawn - wearing long pants and sleeves and socks, you'll be just fine.

I have no idea who your travel health professional is, and I am certainly not one - but Botswana is wet, hot and humid and ripe for mosquitos, beats me why someone would say "not to take or not needed." If for some reason, you cannot take Malarone, there is always the doxycycline (a generic antibiotic) that can be prescribed. This, however, has serious side-effects - sun sensitivity, women tend to get yeast infections, and you have to take the pills for a month after returning home.

Personally,I wouldn't not take the meds, but in the end you have to make your own decision.
 
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Apr 6th, 2004, 02:09 PM
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We were in Nigeria in February, peak dry season and therefore a low mossie risk. On advice from our hospital travel clinic, we took precautions anyway. Got supplies and good info from http://www.travmed.com/

Used Ultrathon when outside, slept under a mosquito net, and used Permethrin on clothing. Also bought a "Buzz Off" shirt that is pre-treated with Permethrin. AND we took Malarone - no side effects, and only problem was the cost! Our health plan only covered the Rx if you actually HAVE malaria when it is used to treat. (Not very logical, but there it is.)

After we spent the $$ to fill the Rx at our local pharmacy, I discovered we could have saved a lot buying it from an authentic online pharmacy such as drugstore.com. Too late for us, but might help others who need it.

And by the way, despite the alleged low-risk season, I heard that one of our party who did not start the Malarone soon enough got malaria on day 2 in country.

For us, it was worth the peace of mind and good health to be take the recommended precautions. But as Sandi said, decision is yours.
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Apr 6th, 2004, 11:31 PM
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That is a *great* tip because it is shockingly expensive otherwise.

>I discovered we could have saved a lot buying it >from an authentic online pharmacy such as >drugstore.com.
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Apr 7th, 2004, 01:14 AM
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Here is a cost saver for the repeat Africa visitors.

I was in Nairobi recently and picked up 8 Larium pills for the equivalent of $4. No prescription needed.

Drugstore.com has 10 Larium pills listed for $114 (that price seems very high to me).

You could probably do the same with malarone.
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Apr 7th, 2004, 03:39 AM
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sandi
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If you have a drug plan, then the cost of about 21-Malarone tabs would run about $50 maximum; without a plan in the range of $100 +/-. So you should shop around.

But like Visas, passports and/or any medicine or inoculations required, have to be considered as costs associated with your trip. Not unlike special clothing needed, a soft-sided piece of luggage, unscented deodorants/body lotions, insect repellent - though many not in the same price range (for only a single item) - all have to be consider before booking and venturing out on an African (Indian, S.E.Asia and the likes) holiday.
 
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Apr 7th, 2004, 10:20 AM
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Just went to a travel clinic a couple days ago, and came back with a travax document (system the clinic uses to identify needed meds/ vaccinations) : "risk exists from November to May/June in the northern parts of the country including the Boteti River, Chobe, Ngamiland and Tutume and the Okavango Delta Region". During typical years, you don't have to take malarial meds in July/Aug/Sept/ Oct, but this can change based on rainfall and water level...and as Sandi noted, the waters/ floods will be particularly high this year. So plan accordingly...
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Apr 7th, 2004, 11:39 AM
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Thanks to all!! Following your advice, I telephoned and convinced my doctor to prescribe Lariam (their formulary, so I had no choice in meds). Your help was essential - I quoted one and all, and that made the case. Thanks!!!
 
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Apr 7th, 2004, 04:57 PM
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sandi
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SoBeTraveller - what do you mean by "their formulary?" Did some pharmaceutical rep recently visit your physician's office? If this professional doesn't know what the issues are/have been with Lariam, I'd be questioning his/her credentials.

There has been some serious history with Lariam, though most people usually have weird dreams and interrupted sleep - it was a godsend when Malarone became available, and is the script now being written. Even on the CDC page, Malarone is the first listed - gives you an idea of what they recommend. It would have been better had the physician prescribe doxycycline than Lariam.
 
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Apr 7th, 2004, 05:31 PM
  #10
sandi
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Queenie - Lariam and its' generic "mefloquin" (sp) is available in Africa; Malarone however, is not readily available in Africa.

As to the $114 price for 10 Lariam - that is expensive. The cost should be $9-$10/tab (if lucky you might find it for $8). Have no idea whether the generic is actually less expensive - I've only used Malarone since its become available.
 
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Apr 7th, 2004, 11:15 PM
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Seriously shocking that doctors overseas still subscribe Lariam. We have been having guests over the years who got sick 2 days every week when they took their Lariam. Upset stomach and nauseous feeling are the mild side effects.
You can buy malaria dugs at the chemist at Johannesburg airport or even at the Maun pharmacy for a fraction of the price you pay overseas - they work just as well.
Local people don't take drugs simply because we would have to take them for month and months. For visitors I would strongly advise to either take prophylaxis (and remember you have to keep taking it after your return home for a while - ask your doctor).
Or else be extremele careful and use mosi nets, peaceful sleep (anti mosi spray etc).
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Apr 10th, 2004, 05:28 PM
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We are kist back from Botswana. We used insect repellent and I was very lucky. I don't think I had one bite but one of the fellows we travelled with was absolutely covered in huge mosquito bites. He was taking Malarone and was happy to be doing so when the mosquitoes found him so delicious.
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Apr 12th, 2004, 06:59 AM
  #13
SoBeTraveller
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Have used Lariam twice and no issues whatsoever. Yes, formulary. I realize Lariam excites a few but the issue has been beat to death, Sandi.
 
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Apr 12th, 2004, 02:29 PM
  #14
sandi
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You asked - we answered. Do as you choose, or not.
 
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Apr 13th, 2004, 07:26 AM
  #15
SoBeTraveller
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Personally, I prefer weird dreams, lol. Have a good one!
 
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