How not to get Malaria

[Enrico]

I would like to have an open discussion about Malaria and maybe assist in answering some questions that people may have about Malaria like:

1. How to prevent Malaria
2. Which medication to take
3. Where are the danger areas
4. What are the symptoms
5. Malaria and children

or any other questions that you may have. Malaria is a killer but can be prevented and can be cured as long as people are aware.

I strongly advise that you visit a travel clinic.

Please post your questions

[SinWolf]

Enrico... Is dit jy ?? CJ se vriend ??

[Oppers]

I would like to have an open discussion about Malaria and maybe assist in answering some questions that people may have about Malaria like:

1. How to prevent Malaria
2. Which medication to take
3. Where are the danger areas
4. What are the symptoms
5. Malaria and children

or any other questions that you may have. Malaria is a killer but can be prevented and can be cured as long as people are aware.

I strongly advise that you visit a travel clinic.

Enrico, brilliant idea! I know most of these have been discussed, but as all the points you raised are valid concerns, and one can never know too much on this topic, would you be kind enough to answer them?

[Henris]

This has been discussed numerous times.

I can give you a quick summary.

People like me that stay in malaria areas.
We believe that he drugs are bad for your system and damage your liver and kidneys.
We also believe that we have some sort of resistance to malaria, because we don't pick it up as easily as the city slickers.
We believe that you have to respect the malaria and make sure that you take the evasive action. Repellents, long sleeved clothes, mosquito nets, etc.

People that stay outside of malaria areas.
They believe to take the drugs. Which drugs is another debate all on it's own.
Then follow the evasive defences.

[WHH 001]

daar 4 pille op die mark die beste is

Malanil

maar gaan praat met jou GP voor jy gaan

dit het baie te doen vir hoelank jy die pille gaan neem
en hoeveel jy wil betaal

[WHH 001]

Hoop dit help

[MikeAG]

Henri,

do you use Coartem once you notice the early symptons of malaria? What difference has it made to the way in which people protect themselves from malaria........by that I mean has the availability of such a good drug made people more slack about covering up and putting on repellant?

I completely agree with your summary. Visitors to malarial areas have the luxury of being able to take prophylaxis. Long term residents don't have that option as the drugs aren't licenced for use in the long term. Visitors who don't take the drugs are nuts, as are people who sit around unprotected in shorts and tee-shirts through the evening.

As for the prophylaxis, I would take Malarone (Malanil in SA??) if it didn't require a mortgage to buy. My brother spent almost $1000 aussie dollars on the stuff for a 3 week trip. Malarone appears to be virtually side-effect free. I have always taken Lariam (mefloquine), and have had no problems. It isn't recommnended for those with any mental health issues, and should be taken well in advance of travelling in case one develops a reaction such as nightmares or depression......leaving you plenty of time to swap to an alternative drug. I have got into the habit of breaking the tablets in half and taking them at half-weekly intervals, to even out the amount of drug in my system through the week.

I am minded to try doxycycline next time. It is cheap and effective, but leaves you more susceptible to sunburn (photosensitive). I have travelled with people a couple of times who took it and they had no issues.

Don't take any notice of anyone who says that garlic or quinine or tonic water will act as prophylaxis. This is idiotic.

Mike

Guys, do you think we could stick to English in this thread please? OP was in English, and this will be referred to by many visitors to Africa who don't understand Afrikaans. Thanks.

[petermoffat]

Is Larium the one you take weekly? That stuff put me off malaria pills for good after the first time I used them.

Had very vivid dreams every night I took them, culminating in a dream about a beetle crawling into my ear and making a racked while I slept. In the dream it was so bad I just kept scratching at it, till I eventually got the bugger out and chucked it next to my bed.

Next morning I had severe pain in that ear and had a mate look at it, turns out it was the pills, and I had scratched a nice chunk of skin out of the inside of my ear

Fortunately it was our second last day in Moz, but by the time I got back to SA, it was pretty infected.

Now I don't take pills, and just make extra careful to get any flu symptoms I may have during the next month or so checked out, and always let the GP know I've been to a malaria area. I don't spend more than 4 or 5 days there anyway, so symptoms will only set in after we return..

[ralton]

yes, i agree with Malanil as a very good option, but it is expensive.
and then take care by dressing properly and applying "poison".
and finally, if you feel ill when you get home, go straight to the doctor and insist on a malaria test - catch it early and you're probably gonna be ok...
cheers

[Berty]

Larium is the one that makes you loopy. The problem is it is very very good at preventing malaria.
It also cannot be used when diving, something to do with increased partial pressures.

There is a side effect free weekly one, name escapes me, but it isint licenced in south africa. Illovo issue it to their staff in the rest of afica. Very good stuff.

[THE EDGE]

What is the cost of Malanil?

I'm also going into a Malaria area in December, would like to give the Malaria a miss!8)

[Raider4x4]

Goodday all, below are some notes on Malaria, I chose not to discuss the use of prophalaxys extensively, it comes down to personnel choice, there are advantages and disadvantages to the use of it, my personnel opinion is that theres far more advantages to using the medication than not using it.

1.) How to prevent Malaria.
• Wear long sleeved pants and shirts, dawn and dusk is when the mosquitos are most active, make sure to wear shoes that’s closed, plakkies with long pants defeats the purpose, and just wearing socks with your plakkies aint gonna do the trick, it needs to be a closed shoe.
• Use repellant, burn incents etc to keep the mosquitos away.
• Contact a General Practitioner or hospital in the area you want to visit and ask them what form of Anti-Malaria is being used for that specific region, as well as dosages and treament and availeablity of the medication.
• Use of prophalaxys has been debated endlessly, if you have a low immune system, get sick easily, or have not lived in a Malaria area for extended periods of time etc use the prophalaxys, if u feel that you don’t need it then its up to you.

2.) Medication

• Prophalaxys, most commonly used right now as :
-Doxycycline
-Malarone

• Treatment, most commonly used:
- Quartem
- Artesunate + Amodaquine
- Quinine IVI

3.) What are the signs and symptoms:

- Sudden onset fever +++
- Headaches +++
- Bodypain
- Generalised flu-like systems.
- The most important sign / symptom is the fever, you will experience a sudden onset fever, which will rapidly increase and then stop very abruptly, it is at this stage that you will think to yourself that its probably just your imagination etc, Fever associated with malaria is of rapid onset and increases very quickly, at first the duration of the fever is for short time periods and gradually increases in both length of fever episode and actual temp.
- Naussea and vomiting
- Diarhea
- Discoloration of urine (dark orange-brown)
- Visual illusions
- Dementia

4) General important notes
- Malaria onset is very rapid, from first moment that you don’t “feel well” to being very sick happens very quickly
- Study the area where you will be going on holiday and make sure to find out what type of Malaria is present in that area as well as treatment specifics and advised prophalaxys
- Incubation period can be upto 2 weeks if not longer, so be sure to tell the docter or medical personnel if you were on holiday in malaria area.


Regards,

Okkie

[WHH 001]

Malanil pack of 12 = R476

[LRE]

Got out of bed about three weeks ago from a bout of malaria. The headache started the evening and when I reached the doctor the next morning, after doing his questioning and poking, his last question was do you feel bad, really really bad? On the yes answer he said Coartem now, blood tests etc can be done later, but Coartem immediately, it can do no harm in comparison to what the Malaria does.

I really appreciated his approach - malaria is a serious matter

Two of us had the malaria after the trip, both on some form of prophalaxys and it seems that it did help to minimize the effect of malaria. I believe the mozzie got hold of me in the car early morning, so do consider "dooming" the car as well.

[slodj]

Henri,

I have always taken Lariam (mefloquine), and have had no problems.... I have got into the habit of breaking the tablets in half and taking them at half-weekly intervals, to even out the amount of drug in my system through the week.

Is this safe, as the maximum plasma concentration in your body will be reduced, thus (theoretically) reducing lariam's effectiveness?

From the (mefliam) pamphlet:

'The maximum plasma concentration after a single oral dose is reached in 6 to 24 hours (average 17 hours). The achieved plasma concentration in nanograms per millilitre is roughly equivalent to the dose in milligrams. In steady state with weekly doses of 250 mg, maximum plasma concentration of 1 000 ng/mL have been recorded. Mefloquine is 98% bound to plasma proteins.'

[MikeAG]

Well, I start off the course by taking full tablets for a couple of weeks before I leave home. Secondly, if maximum plasma levels are achieved in 6 to 24 hours, what are the levels at the end of the week.........6 days after maximum plasma levels are achieved, and just before you take the next tablet? I'm not sure that the maximum level is what determines the effectiveness of this drug...........it surely is more important for the average level to be above the effective dose, and that the minimum level doesn't fall below the effective dose.

I have no proof of the validity of this approach, and for 10 years I took whole tablets weekly. My logic is that taking it weekly means high levels of the drug in my system at the start of the week, reducing to low level by the time it comes to taking the next pill. By taking half pills at half weekly intervals, that low level problem is reduced.

As one who always advocates listening to the scientists and doing as they say, I am breaking my own rules in this case. If an expert told me I was wrong doing this I would happily return to the old way (academic, I guess, as I am moving over to Doxycycline next time anyway!).

Mike

[Liebs]

My Nobile Opinion, Experience:fficeffice" />>>
1. Avoid travelling to malaria areas with kids younger than 2 or weighing less than 15kg. It's very difficult to treat them when they get malaria.>>
2. be careful when taking prevention medicine, since it tends to hide malaria systems in the beginning.>>
3. If you do get malaria it is best to go to the local Hospital or clinic in the area since they will have the right treatment for the specific string.>>
4. If you or anyone who traveled to malaria gets a cold or get sick within 3 Months go to the doctor and mention where you were and when.>>
5. People who live in malaria areas do get some immune against it and this is inherited to their children, but stands the same change to get malaria when travelling to areas with different strings.>>
>>
Just my Thoughts>>

[MikeAG]

2. be careful when taking prevention medicine, since it tends to hide malaria systems in the beginning.

I believe that this is a quite dangerous mis-conception. I understand that there is no masking effect. What there is, however, is a reduction in the effectiveness of the old post-contact treatments, especially Fansidar, as a result of taking some prophylaxis (I'm not sure which of them). This is no longer important because of the emergence of the coartem family of drugs.

5. People who live in malaria areas do get some immune against it and this is inherited to their children, but stands the same change to get malaria when travelling to areas with different strings.

People who live in malarial areas do acquire some.......some........immunity. However, this is soon lost if you leave that area for a length of time, and I don't believe I have ever heard or read of any evidence that this immunity is passed on to children.

There has been a 3 miilion year long experiment in this. If immunity was acquired by children then malaria would no longer exist. It is still one of the biggest killers of children in Africa, and this amongst people who have lived in malarial areas for millenia. So, I would take an awful lot of persuading that there is any acquired immunity phenomena. Sickle cells are regarded as part of the immune response of a population to malaria, and are associated with a reduced mortality. However, this is a genetic weakness in itself, and can lead to sudden premature death........and they aren't acquired by white people living in a malarial area.

Did you know?.........It has been estimated that a third of all the humans who have ever lived were killed by mosquitos!

Mike

[Tony Weaver]

[QUOTE=2. be careful when taking prevention medicine, since it tends to hide malaria systems in the beginning[/QUOTE]

This is the biggest misconception of them all about malaria: The entire point of taking prophylaxis is that it DOES hide the symptoms - the symptoms ARE the disease. You still get malaria on prophylaxis if bitten by an infected anopheles mosquito, but the prophylaxis fights back and defeats it. If you get mild symptoms, you have the disease mildly. If you get severe symptoms, you have the disease severely. Saying that prophylaxis hides the symptoms is like saying that paracetamol hides the symptoms of a headache!

[tgwinduna]

This is the biggest misconception of them all about malaria: The entire point of taking prophylaxis is that it DOES hide the symptoms - the symptoms ARE the disease. You still get malaria on prophylaxis if bitten by an infected anopheles mosquito, but the prophylaxis fights back and defeats it. If you get mild symptoms, you have the disease mildly. If you get severe symptoms, you have the disease severely. Saying that prophylaxis hides the symptoms is like saying that paracetamol hides the symptoms of a headache!

Hi Tony
100% correct . I grew up in Malawi in the 60's and as a child I had malaria many times a couple of times very bad. The cure then was Chloroquine tablet or injection ( a quinine based drug) but however you still got re occuring malaria even though you had not been bitten.
I spoke to Dr Andrew Jameson from BA Travel clinic at a getaway show many years ago about my history and now living in SA for a long time. Was it necessary to still use a prophylaxis. His words were " The difference between living and dieing was the difference between taking a prophylaxis or not" had I been bitten. There has been note an lariam as to the side effects of it. It has been known to emulate malaria symtoms and medical docs found it hard to detect on someone using the drug. The rules of engagement is to bomb with cortem irrespective can do no harm.My family still living in Malawi use Fansada or cortem and there is another drug from Chine which is very good only one tablet. It puts you on your back for a day and thats it, It kills every malaria parasite in your body.I think it is called Narataki or something like that and it costs $100 US. I Think it is imperative if you are going into or close to a know malaria area anytime of the year you must take a prophylaxis and also carry one or two cortem packs with you if you are going for more than 10 days.