"I don't think it's necessary, your highness, to call anyone arrogant." 1Caroline

Your highness... good one!

However, I was not speaking to you in particular, never a very satisfying proposition. I was referring to those who may feel that they cannot trust any medical system but our own and encouraging those without prejudice to consider all options if circumstances allow.

I suggest that no one trust Caroline in these matters and I also suggest that you not trust me. It's important when making these sorts of decisions to trust no one source where your health is concerned including the medical community without researching matters thoroughly.

I can agree completely with your last statement.

Saying that "It's arrogant in the extreme to assume what we get in the US is any better than abroad" strikes me as being gratutitous: No one here said the US drugs are better than anywhere else. Some things are just incontrovertible, including the fact that drugs in the US are of a very high quality, that questions can legitimately be raised about the quality of some drugs (including some of interest for travelers, e.g., antimalarials) in many countries, and that the counterfeit drug trade in places like Africa and Asia (including places like Thailand and Bali) is fairly high. Those who want to be assured that they are getting a quality product (especially if their health is compromised in some way), who are not inclined to do time-consuming research to find acceptable foreign pharmacies (and perhaps still have some qualms about what they're getting) or who are not overly concerned about cost, are hardly being elitist when buying in the US or suggesting that option. They are simply making what seems to me a sensible decision.

I was simply addressing the concept that good care can be found in 3rd world countries at a fraction of the cost of that in the US if cost is a factor. I was not addressing anyone in particular, only saying it's something to consider, not to be discounted on the basis of an arrogant notion that everything we have is better. If cost isn't a concern then it's a moot point. If someone is already in Asia and in need of care, vaccinations or medications good care is available. Not everywhere, of course. I present it simply as an option, not as a cause for dissension.

Hi webale, just came back from amazing Africa and I feel like leaving again!
I didn' t have any prophylaxis at last, but many of my travelmates had tetracycline Bassado, which cost around 3 Euros. In my group there were a Doctor and a nurse and even them they choose not to have prophylaxis.
You have to protect yourself from mosquitos anyway and all rooms have a tent for protection over the bed.
great great great Africa.

>> even the doctor and nurse didn't use any............

As they say, 'doctor heal thyself, as you're often the worst patient.' Too sad and hope neither bring home malaria as a souvenir from their travels. Know also that symptoms of malaria don't always appear immediately; it can remain inactive in one's system for well over a year or even two and then joila... you feel like death! And have to remember where you had traveled over that period of time... ugh!

tetracyline? is not the same as doxycycline which is offered as an alternative to Lariam or Malarone? Both in the same family but have to wonder whether the former works as does the latter?

Sandi, I just had to look it up. Turns out Bassado is one of the quadrillion names doxy goes by. Who knew!?

Hello, I did not want incite anyone to avoid prophylaxis, but I decided to tell my experience in a totally truthful, to be useful to other travelers. I do not consider malaria a no-brainer and I came to visit a doctor specialized in tropical medicine at the nearest hospital before leaving. I had my doubts, but even before to express them, my doctor told me that he did not think it was necessary, since in any case I couldn't help to protect myself from mosquitoes (long sleeves and repellent). When I arrived in Uganda, to meet the doctor and the nurse who had not followed the prophylaxis has undoubtedly made ​​me feel better. No less crazy, I confess. I believe there is a measure of subjectivity always difficult to calculate. They say that the Lariam give big psychological problems, but one of travelmates that took it was the most peaceful of the group. Other girls have opted for homeopathic medicine taking Ladum. The tour leader took Bassado, still scared for malaria contracted in Mali 20 years ago. When she was hospitalized, at the time, some doctors told her that prophylaxis had saved her with decreasing the virulence of the disease. Other doctors said instead that without prophylaxis malaria would have been diagnosed and treated more quickly better. I keep reading comments diverses and i wasn't able to get an opinion yet, but I am very interested because I want to travel in Africa again and again. Thanks anyway for your answers and sorry for my English.

Since this thread was started there have been reports about the development of an actual vaccine for malaria, welcome news indeed:

http://www.cnn.com/2013/08/08/health/malaria-vaccine

Yellow Fever Card is mandatory for travel to Uganda.

MmePerdu - thanks for that link which I added to the threads found on Trip Advisor (both Tanzania and Kenya forums). Still not time to feel meds are not needed. Too many years down the road before available for those who need first, not us tourists for sure.

sdb2 - thanks for that info; figured same family of cyclines but had never seen tetra mentioned.

When in doubt with regards to Malaria, you go with the meds and proper attire during mossie biting time - dusk-to-dawn - along with repellent. You'd also be surprised how many so-called tropical diseases specialist (in the West) still don't know what to check for when patients arrive with symptoms. You're almost better off getting the disease while in-country where most everyone knows immediately when they're not feeling well and go for treatment. It's simply a nasty disease that kills.

A friend contracted malaria over 30/yrs ago, and still today remnants of the disease attack her as sadly it remains in your system for life.

Just don't forget the repellent all the time..

I'm sure most people would know this anyway, but just in case, our doctor said that anyone traveling abroad and having an undiagnosed illness in the next few months, should alert his/her physician upfront that they had been traveling abroad. That, of course, gives the doctor the opportunity to test and rule out any of the common illnesses associated with traveling to some countries.

street_sadu: Our travel meds doctor told us we definitely didn't want Larium. As you said, they too said that it has lots of Psychological effects for many people and that they are often long term effects. I know some will debate that point, and that's okay with me, but I prefer to listen to the doctors who know travel meds. They prescribed Malarone for us and everything was fine.

The variables in prescribing 1 medication over another have nothing to do with side-effects but everything to do with location. In some areas there are forms of the disease resistant to one or more medications so another must be used if you plan to use one at all.

Another example of never getting one's most important travel information from a forum.

While choices may or may not depend on the location, no one wants to have long term psychological side effects from any medication if it can be avoided by simply using another medication. That's the bottom line.

Of course decisions on what antimalarial to prescribe take side effects into consideration. Once the destination and probable resistance are addressed, the physician will have a choice of antimalarials to choose from. Many doctors will not prescribe Lariam to first time users for fear of significant (as in ruin one's holiday) psychological side effects. With respect to sub-Saharan Africa doctors are apt to look at doxycycline or Malarone, both of which tend to give less severe effects.