Cerebral malaria!!

[DJR]

Just to add my voice (drum beat?) for meticulous malaria prophylaxis, diagnosis and treatment.

[Engel]

I work in a very high risk area and it is about looking after yourself.

What works the best for me , nevermind the long sleeve shirts, malarone, mosquito nets etc, stay away from local congregation on people like bars at night etc.

[Stan Weakley]

And bad women!

[Engel]

oom stan, jy kry n anner siekte van daai goed af!

[Stan Weakley]

Ja 'n verkoue en lopende neus op 'n ander plek! Miskien is malaria beter?

[Engel]

sies!! haha

ek sien dengue fever is ook besig om sy kop uit te steek, en hy STEEK in die dag.

Ook n fatality gehad waar n man behandeling geweier het na malaria diagnose

[BigRed]

Maybe this is a stupid question, but is it possible to have had malaria without knowing it, perhaps thinking it was a really bad case of flu?

I've wondered about that too....

Would a test show if you have previously had malaria?
Thanks for a really interesting topic and all the advice.

Is Malaria not similar to Rickettsia virus, meaning it will only show up in a test when in the active (fever) stage?

[Stan Weakley]

Yes microscopic examination of your red blood cells can falsely yield a negative for the malaria parasite occasionally. Therefore if malaria is a possibility repeated tests must be done. One or even two negatives is not enough.

In the vast majority of cases the diagnosis is made on the first test. It is vital that a visit to a malaria area is emphasized in your medical history when an unexplained illness occurs. Malaria will often not be picked up with routine blood tests, it has to be specifically looked for.

[joeinmoz]

clebral malaria acts differently to normal malaria and in most cases over seen until much later....one factor that contributes to this is anti malaria medication that actually masks some strains but not others...i have heard of some cases where someone is treated for malaria but because they had taken some sort of preventative medication the true strain never showed up and they got very sick indeed....ive been living in moz for 15 years and NEVER had malaria...sounds like utter garbage but true...in my humble opinion dont take anti malaria medication as it can subdue it until much later...as soon as you get home visit a travel clinic or your GP and get checked. If you start having headaches, nausea, joint pains you probably have it so get yourself checked as soon as you get home and get treatment. some people before leaving moz go to the local ICOR hospital in Maputo for a test, takes 45 min and presto...plus they know exactly what to look for as they do this every single day of their lives...they are really good at it.

last bit of advice: malaria carrying mosquitoes are not born with malaria..they simply transmit it so stay away from crowds, apply a good dose of footsek (bugger off) spray and before going to bed spray your room or tent with baygon or whatever and let it hang in the air for 30 min before going to bed. Mosquito nets dont work...these local mozzies are educated in mozzie nets and always find a way in... :-)

[Gareth]

clebral malaria acts differently to normal malaria and in most cases over seen until much later....one factor that contributes to this is anti malaria medication that actually masks some strains but not others...i have heard of some cases where someone is treated for malaria but because they had taken some sort of preventative medication the true strain never showed up and they got very sick indeed....ive been living in moz for 15 years and NEVER had malaria...sounds like utter garbage but true...in my humble opinion dont take anti malaria medication as it can subdue it until much later...as soon as you get home visit a travel clinic or your GP and get checked .... Mosquito nets dont work...these local mozzies are educated in mozzie nets and always find a way in... :-)

Control yourselve Stan, Tony, FMaartens, Mike. Use this as a teaching opp ... Lol

[Swys14]

FMaartens thanks for sharing your knowledge here on the forum. It's appreciated.

[joeinmoz]

Control yourselve Stan, Tony, FMaartens, Mike. Use this as a teaching opp ... Lol

Only my 2 cents worth Gareth, it could be only 2 cents but 15 years and never had it and i have lived for extensive periods of time in some pretty bad places in Moz, Marromeu, zambezi, mueda, Beira, sussendenga. Ive had friends almost die from malaria and ive been told that anti malaria medication or rather some of them do more harm to your liver etc etc than good and that some of the strains actually get masked and remain undetected in tests only to pop up later and then it gets serious.

From what i understand in Moz they are classified in x's, there are x, xx and xxx strains and one needs to be properly diagnosed by strain to have successful treatment. Celebral malaria ive been told is classified differently?

Im open to being laughed at...lol...or being educated.

[Stan Weakley]

Unfortunately you cannot buy scientific and medical expertise with 2 cents. As long as everyone understands that joeinmoz's 2 cents worth is an unorthodox, dissenting and unscientific opinion then I would not give him half a cent for it.

[Boyscout]

Thank you for the information about Malaria risk if you don't have a Spleen anymore. I had a splenectomy at age 3. This is honestly the first time ever that I heard about this. Guess that sorts out my future Africa travels

[joeinmoz]

Unfortunately you cannot buy scientific and medical expertise with 2 cents. As long as everyone understands that joeinmoz's 2 cents worth is an unorthodox, dissenting and unscientific opinion then I would not give him half a cent for it.

Lol, thanks Stan, Ive been told this by Doctors here and have never strayed from this advice and until now ive never had it...mabye its the 2 years i spent in the army in Phalaborwa patrolling the Moz border and taking those horrible pills that made me resistant or just possibly plain luck but ive been told on various occasions not to take preventative medication. Being here and seeing alot of friends driving to Nelspruit for checkups for Malaria as they feel crap and being told negative only to arrive back in moz they pop into a local clinic as a last resort (off course) and bang there it is and they are then treated successfully. i dunno...ive seen this a few times and just makes me weary about the diagnosis and the anti malaria pills out there that there could be merit in what the local docs tell me. Is there any chance that anti malaria pills could actually mask initial diagnosis?

[Stan Weakley]

Hey Joe!

There are many misconceptions about malaria, many of which started in the army with those terrible prophylactics we had to take in those days. Poor suntan, masking the diagnosis, affecting your relationship with your girl back in the "States", I heard them all as a National Service Doctor.

No, malaria prophylaxis does not mask the initial diagnosis. It is indeed true that the first tests (blood smears) for malaria may be falsely negative. The incidence of false negatives is the same whether on prophylaxis or not. Malaria tests should be repeated until you are better or the diagnosis is confirmed.

It is to be noted though, that many people working in malaria areas have free access to the oral treatment for malaria in the form of Coartem. When they feel ill they just start the tablets which they have at hand, without a definitive diagnosis of malaria having been made. When they start feeling better then the Coartem is stopped before a full course has been taken, in the belief that it was not malaria in the first place. This situation of partially treated malaria can delay diagnosis.

There are really 2 issues here. One of which applies to you and the other to most members of the forum. It seems as if you have chronic exposure to malaria, there is still debate about the place of chronic long-term prophylaxis here. With the advent of Malarone I would personally take this prophylactic long-term, in your position. It is effective, safe and has now been cleared for increasingly long-term usage. The biggest problem with prolonged usage was the expense, obviated now with a generic, Numal, at just over half the price. The single biggest risk factor for contracting malaria is a prolonged period of exposure and it seems you qualify.

The second scenario for malaria prophylaxis is for short-term exposure. There is no logical argument for not taking prophylaxis here. This policy is strongly advised by the World Health Organization and every National Health Institute, without exception.

You are perfectly entitled to do what you feel is best for yourself. You are also entitled to your opinion. However I am compelled to intervene when your expressed views have the likelihood of causing harm to others.

I quote again the scariest adage about severe malaria - "fever in the morning, dead by that night".

[joeinmoz]

Hey Joe!

There are many misconceptions about malaria, many of which started in the army with those terrible prophylactics we had to take in those days. Poor suntan, masking the diagnosis, affecting your relationship with your girl back in the "States", I heard them all as a National Service Doctor.

No, malaria prophylaxis does not mask the initial diagnosis. It is indeed true that the first tests (blood smears) for malaria may be falsely negative. The incidence of false negatives is the same whether on prophylaxis or not. Malaria tests should be repeated until you are better or the diagnosis is confirmed.

It is to be noted though, that many people working in malaria areas have free access to the oral treatment for malaria in the form of Coartem. When they feel ill they just start the tablets which they have at hand, without a definitive diagnosis of malaria having been made. When they start feeling better then the Coartem is stopped before a full course has been taken, in the belief that it was not malaria in the first place. This situation of partially treated malaria can delay diagnosis.

There are really 2 issues here. One of which applies to you and the other to most members of the forum. It seems as if you have chronic exposure to malaria, there is still debate about the place of chronic long-term prophylaxis here. With the advent of Malarone I would personally take this prophylactic long-term, in your position. It is effective, safe and has now been cleared for increasingly long-term usage. The biggest problem with prolonged usage was the expense, obviated now with a generic, Numal, at just over half the price. The single biggest risk factor for contracting malaria is a prolonged period of exposure and it seems you qualify.

The second scenario for malaria prophylaxis is for short-term exposure. There is no logical argument for not taking prophylaxis here. This policy is strongly advised by the World Health Organization and every National Health Institute, without exception.

You are perfectly entitled to do what you feel is best for yourself. You are also entitled to your opinion. However I am compelled to intervene when your expressed views have the likelihood of causing harm to others.

I quote again the scariest adage about severe malaria - "fever in the morning, dead by that night".

Thanks Stan, straight from the horses mouth as it were and i will definitely start taking Malarone from now on, prevention is better than cure and if there are no long term negatives then no reason not to take them. i was so strongly advised not to take them that i believed it...stupidly it now seems.

Thanks again for clearing my misconception up.

[Stan Weakley]

Thank you for the information about Malaria risk if you don't have a Spleen anymore. I had a splenectomy at age 3. This is honestly the first time ever that I heard about this. Guess that sorts out my future Africa travels

It all depends how badly you want to travel in Africa. If the need is great, then plan to go during the lower risk dry season, choose lower risk areas to visit, be very diligent with prophylaxis, make absolutely sure you do your best to avoid being bitten by mossies. These measures would include liberal mossie repellant spray, soak your clothes in one of the solutions you can buy for this (Outdoor Warehouse/chemists), wear long sleeves, long trousers and socks especially at night, Doom your tent or sleeping quarters, mossie net, mossie coils, citronella candles etc.

Have a very low threshold for urgent medical attention should you become ill. Finally the best advice is that from a personal medical consultation. Best to see a doctor specializing in travel medicine at your nearest Travel Clinic. He may give you some Coartem to take along for temporary emergency treatment whilst on your way to medical care.

[Shemula]

I was born in a malaria infested area (Kenya) and had malaria as a child 7yrs old and never again and for the last 20 odd years I once again have been staying in a malaria area (Ndumo) still not had Malaria. That does NOT mean other people can and will be so lucky. My late father in law was in this area for 3 months and passed away with celebral malaria.
One thing you do not ever do with malaria is generalise as an infected mosquito area is always dangerous regardless of how careful you are and how well you are prepared.

[BlomCo]

@ Stan, I went to see a (travel) doctor at our nearest Intercare Centre. He basically described the different types of pills/prophylaxis one can take during a visit. I asked for 'a better quality' (cause it's our honeymoon ) and he prescribed the Numal. My question to him was and to you is, If one takes the pills on schedule and every single day (being almost paranoid, as I also don't have spleen), is it possible to get Malaria? Or is it 100% impossible as long as you use the prescription on time and as prescribed?