We are plaaning a safari in Tanzania in June '08. Our doctor is suggesting Lariam pills for malaria or perhaps Cloroquine. I read in a tour book that Lariam is an older medication with lots of side effects while Cloroquine or Malarone are newer meds with very few side effects.

Does anyone know what works the best? Are there meds that are better suited for the Tanzania region? How bad are the side effects?

Many thanks!

We took Doxycycline with no ill effects. It was the one most easily available where we live, and we read it was effective.

Davgai

I am going to take Malarone. It is expensive but you take it for a lot less days. Doxycycline is cheaper but you need to take it for a much longer time, often long after you are back. Doxycycline also causes sensitivity to sun so if you burn easily this would not be the best choice. If you are a diabetic and prone to yeast, Doxycycline is an antibiotic and puts you at risk. All drugs have side effects but when a trial is done, all symptoms are listed even if they have nothing to do with the drug. Gail

I highly recommend that you read the Center for Disease Control's (CDC) website pages on "Malaria Info. for Travelers" and "Health Info. for Tanzania":
http://wwwn.cdc.gov/travel/destinationTanzania.aspx
http://wwwn.cdc.gov/travel/contentMa...ugsPublic.aspx

Please note the CDC states that they feel Cloroquine to be an ineffective anti-malarial for Tanzania. The CDC site should be able to answer all your other questions concerning malaria, as well, such as those concerning side effects of Larium.

I have not visited Tanzania, but I have taken Malarone for three different trips. I chose Malarone, even though it is more expensive and must be taken daily, over Larium/Mefloquine because Malarone is not as likely to produce as serious side effects. Also, in many areas, Plasmodium falciparum (the most deadly of the protozoan species that causes malaria)has developed resistance to Larium/Mefloquine.
This being said, many years ago, before Malarone was as readily available, I took Larium for a couple of trips, without experiencing any side effects, however I would not want to take this risk again.

Hi, I took Lariam when I first went to Africa in 1999 and will never take it again. I wrote a letter to my parents telling them that if anything happened to me when in Africa they were to ring the bank, get my bank balance and fill in the blank cheque I had included, to the amount of the balance of my account. Needless to say they thought I was going to do something to myself. I had recurring nightmares about being taken by a lion and the paranoia I experienced was really terrible. I was sick 3 times during the month I spent in Africa and whilst not necessarily due to the Lariam, I am sure it had something to do with it. I have subsequently taken Chloroquine and Paludrine, both of which made me feel sick. I have been living in Africa full time since 1999 and after the first 2 attempts at taking pills for malaria, have opted not to take anything and touch wood, I have never had malaria and I live in a malaria zone.
Many of my friends and my parents have visited and most of them have been prescribed Doxycycline, which is a broad spectrum antibotic. It does make you prone to sunburn, however that is nothing that sunscreen, long sleeves and a hat won't fix. Doxy will also kill other bugs you may come in contact with, especially waterborn bugs.
My advice to you is to be diligent, never go out after 6pm at night without long pants, long sleeved shirt and boots. Always use insect repellent, spray on exposed skin and on your clothes, both during the day and at night. Always sleep under a mozzie net and make sure you spray your entire body before going to bed. It could be the one time you get up in the middle of the night to go to the toilet wearing little clothing that the mozzie takes the advantage. Try to be in bed by 10pm at night as the malaria mozzies are out hunting between 10pm and 6am each day.
Be aware and be careful, that is the way to enjoy yourself while on safari.

Hi Ann7544

I would advise you to go to a Travel Doctor as this is their speciality. Your local Doctor does really not know enough about it, it is a specialised field.

What you take will also depend on what other medications you are on.

It is not worth the risk to take advice from the general public.

Kind regards

Kaye

As a nurse who works in a Travel Clinic, I would second Kaye's advice -- let someone who specializes in the field help you decide which of the 3 effective medications is best for you. Each has its pluses and minuses.

But please do NOT rely on Chloroquine (trade name Aralen) in Africa; there is widespread resistance to this medication throughout the continent (as well as Indian subcontinent and Asia).

Larium is the standard recommendation for non-travel doctors.

See a travel doctor or do your own research. We had an Rx for Larium, but after doing some research, we all obtained new Rx for Malarone. My reasoning was that the chance of having more severe side effects was less with Malarone, plus if you cannot tolerate these drugs, Larium stays in your system longer than Malarone.

Our doctor had no problem issuing a new Rx.

I took Malarone both times I went to sub-Saharan Africa. No side effects or problems of any kind. On the first trip I was with a friend who I had traveled with before. She took Lariam. I sincerely thought she was in the early stages of dementia, as she behaved in a whacky way that she didn't on our previous trip. I didn't make the connection to Lariam until the trip was over.

By the way--my prescription plan covered my malaria medication. They may not all do that, but mine did both times.

Though I am not medically trained, I too would advise against Chloroquine in Africa. It's ok for elsewhere but not the appropriate drug for Africa. In fact several years ago there was a lawsuit against a family doctor who prescribed Chloroquine to a patient for an Africa visit. The guy contracted malaria because this was the wrong drug for Africa and died.

I used to take Larium with zero problems or side effects, but the more recent research has persuaded me to now use Malarone. I have zero side effects with that also.

Best advice--go to a travel clinic where they are familiar with the drugs and the latest on disease. Also ask for some Cipro just in case of severe stomach problems. Then have a worry free safari.

We just got back from Tanzania, and we made the decision to take malarone. We had no side effects; however, it cost over $200 each, and our health insurance did not cover it.

I have taken both Larium and Malarone and I can tell you that with Larium, I had wild bizarre dreams and with Malarone I had no side effects. You must however talk with your doctor.

As for insurance coverage, my company is self insured and like most coverage there was no travel coverage. I found that odd as they cover vaccinations and pills to prevent other diseases.

What I did next, might not be smart, but it worked. If I did come down with malaria, it WOULD be covered through my insurance. So I informed my company that we would share the risk of my getting malaria since I did decided that if they did not cover Malarone, I think they should run the risk of paying thousands of dollars if I got sick.

Shortly after I sent them that information in writing, they decided to cover malarone.

Mike

Thank you all so much for your advice - I'll be sure to take it all into consideration when making the decision!!

By the way, which insect repellant is the most effective? Do you use it for all exposed areas including your face? Is there one type to be used for clothes and another for skin?

I posted about anti-malaria pills on Trip Advisor's Africa forum.

Just about the same responses there as in here. Malarone is what we will be taking.

I will be taking Malarone on my trip to South Africa and my insurance covered it since it was a Tier 3 drug. I only had a co-pay. If my insurance company did not cover the Malarone, I just would have paid for it myself.

Repellent - at least 30% Deet; anything more is really overkill. Like sun protection using 50SPF vs 25SPF; only different with higher SPF is you don't have to apply as often.

As to repellent - NOT on the face or back or neck. Ankles if you don't wear sock (you should), hands. Wash off before retiring for bed.

Lodges/Camps provide repellent spray so have your room/tent sprayed when you go out for dinner (not over your pillows/bedding). The smell will be gone by the time you return.

I never spray clothing, so that's a personal choice.

But for that matter, I've rarely seen and certainly never been bitten by a mossie. Pepper ants and little jiggers, but not mossies!

By June, you're going into the dry season, so often less mossies. And, if you're at higher elevations, i.e., over 5,000' (the Crater is at 7,000') and if cold nights/mornings and windy - mossies stay away.

I’ve taken Lari<b>a</b>m on three trips and will do so again in June as I’ll be spending far too much money even without Malarone. Since I always have bizarre dreams, I can’t say if I have any side effects from Lari<b>a</b>m.

Sounds great - thanks so much!

june is supposed to be dry in TZ so i would avoid any chemical prophylaxis but would take a stand by medication with me.
wear long sleeves and pants and some repellent if in need.

doxi is only for dark eyed/hair people. let's say you are a blonde and light skin you most probly will face trouble because your skin gets extremly sensitive to sun rays. i took it once and could only stroll during sun light with gloves on carrying an umbrella - imagine walking jack's camp carrying an umbrella and doing quad biking with gloves and completely wrapped like a tuareg....wasn't particularly funny - but now i can lough about it ;-)

I've taken Larium in the past, but it seems to affect my eyesight after 4 weeks. I've taken Malarone with no ill effects, but it's expensive.

Last year I had 3 months in Dar es Salaam, from January to end March, and there was no way that I was going to take the risk with Larium for that length of time. Malarone is only licensed for 28 days, so that was no good.

I decided to take Demal-200 (a herbal extract spray sold by Blue Turtle) which I had heard about in Kenya. I discussed it with my doctor and she said that she had seen a documentary about it, but I wasn't to blame her if I had a fever. I took the spray and was fine, and I didn't have a day's illness the entire trip.

One of my housemates took Malarone for 3 months, and her hair started falling out. Another used Doxycycline and caught malaria. A student that I met took Larium, and she started sleepwalking.

I also used a mosquito net soaked in permethrin and I used Mosi-guard repellent, which is a natural product that lasts longer than Deet, according to tests by the London School of Hygiene and Tropical Medicine. In Dar, one of my housemates spilt some deet on the floor, and it stripped off the floor paint.

While I was in Dar I discussed Demal 200 with a doctor living in Dar, who had been researching tropical medicine in Africa for over 20 years, and he said that he woudn't take any of the poisons pushed by travel clinics, but advsed me to buy a course of malaria cure tablets &quot;just in case&quot;. I bought the tablets, but never needed them.