Zambia Malaria and Yellow Fever

[Gary110]

I can categorically state that Mefliam IS NOT the generic of Malarone.

Malarone is still under its patency law, and can thus not be legally copied. However the patency period will expire in the next couple of years and then every second pharmaceutical company will copy the recipe and churn out MUCH cheaper versions. This will not only mean cheaper meds for those of us doing the odd trip into a malaria area, but also for millions of people who live in those areas and require pharmaceutical assistance from time to time.

[Kalahari Safari]

Stan,

Thanks all for the debate and the efforts of explaining the consequences and effects on the medication - great source of info.

However, I have two points:
1) I am one of those who does not take the malaria medication for reasons that I have seen the long term effect on vision deterioration on my work mate who was on constant prophylaxis over a two year period.
2) I am living in the bush quite often and if adhering to those prescriptions I would be taking the prophylaxis almost year round.

Yes, I shopped malaria back in 2000 when staying in the lower Zambezi valley, it got treated (Quinine at the time), I flew out to Europe and it was cured (I was told it was the cerebral type) and no further relapse or any health compromise whatsoever.
This the history and reasoning, now my question:

What to do if you visit the Malaria area say every 2 months, sometimes 3 months in a row, every year with the longest break being about 3 months of not being exposed?

We now know of the possible long term effects and I am unsure where heading to...?

Please don't construe this as a dilution of the core message, but I am really uncertain if I should change my perception after more than 10 years of exposure.

Knowing the symptoms of malaria, what I do as a precaution, I carry those Quinine tablets and in case I would have clear symptoms of malaria, I intend to ingest those tablets to gain time to make it out of exposure and into medical treatment (say within 2 - 3 days).

Any taking on this?

[Thirstie]

I have lived in Malaria areas on and off for 3 and a half decades and never took malaria prophylaxis. I have a violent reaction to quinine and never bothered to look at alternatives as they came out in the later years. I had malaria once when I was 14 and Jacques had it twice during 10 years in Moz.

We are both very aware of the malaria risk and never travel without 4 test kits and plenty of Coartem. We know the signs and a very early warning is when we can't tolerate alcohol and get joint aches.

KS, I agree with you that there must be SOME side effects of taking a prophylaxis endlessly.

Having said that, we encourage all visitors to Zambia and our lodge to take Malarone (as the local fundys seem to prefer it).

[Tony Weaver]

Walter, the general consensus is that people living in malarial areas do develop some immunity, and obviously you can't take prophylaxis constantly. My wife and I were part of the SA trials on Lariam when we were in malarial areas for two years in a row, and the advice from the pharmacologists at UCT were to go off it for three months every three months. My wife and I both got malaria during the "off" periods.
Generally, what Linda is saying is the right advice - carry the test kits and the cure. In many parts of Africa, if test kits aren't readily available, doctors or medics will routinely administer the cure whenever someone presents with malarial symptoms.

[Tony Weaver]

a very early warning is when we can't tolerate alcohol and get joint aches.

Linda, down here in the Cape we just call that a babelaas.

[Kalahari Safari]

Tony,
Where can one get those test kits and what does it contain?

Linda,
Are you taking Coartem as you had side effects from Quinine?
Is it basically the same treatment then?

I think just to get my hands on these items, just in case.
Thanks for the suggestions.

[MikeAG]

Are you taking Coartem as you had side effects from Quinine? Is it basically the same treatment then?

Coartem is the best of the modern drugs, derived from an ancient Chinese herbal remedy.....and it is very different to quinine. Most malaria around the world is no longer responsive to oral quinine (natural selection/ evolution in high-speed action). If you are going to arm yourself with a malaria treatment, then it should be Coartem.

Mike

[Tony Weaver]

Tony,
Where can one get those test kits and what does it contain?
.

Hi Walter,

It's a blood testing kit, finger prick - here we get them through the Travel Health Clinic. In Gaborone, I seem to remember that there's a Cape Union Mart in that big shopping mall on the left as you come into town from the south. They might have, or else ask them to order for you.

[Kalahari Safari]

Coartem is the best of the modern drugs, derived from an ancient Chinese herbal remedy.....and it is very different to quinine. Most malaria around the world is no longer responsive to oral quinine (natural selection/ evolution in high-speed action). If you are going to arm yourself with a malaria treatment, then it should be Coartem.

Mike

Hi Mike,

Thanks will talk to the pharmacist and see if he can organize it.

Hi Walter,

It's a blood testing kit, finger prick - here we get them through the Travel Health Clinic. In Gaborone, I seem to remember that there's a Cape Union Mart in that big shopping mall on the left as you come into town from the south. They might have, or else ask them to order for you.

Tony,

Will check at Cape Union mart, we have actually 2 branches, the one you refer to in Riverwalk, the other one in Game City when coming in from Lobatse.

Otherwise it has to wait until I am in CPT next time around year's end.

Thanks guys for the details
Walter

[Thirstie]

Your pharmacist should have the testing kits too. Just have a good look at the expiry dates. Perhaps Gary can suggest a brand/make as some don't test certain strains of malaria. Or your pharmacist should know.

Your local clinic or hospital should also be able to offer you Coartem and test kits. They use them too.

We carry Coartem because it is the best self remedy product available. I have no idea if I react to it as I have not had a need to use it. I have never heard of a reaction. And Mike is right - Coartem is herbal. They grow the trees by the hectare here in Zambia. There are various teas you can buy that are made from Coartem trees. Forget the name of the tree but they have found that, with prolonged use, they are having a lot of success treating HIV patients especially small kids. Bitter as hell. You can buy it in Myafa Health shop in the Spar complex in Lusaka.

[Thirstie]

I just remembered the tree is called the Artemisia tree. Really interesting uses for general good health, strengthening the immune system etc. Have a read:

Artemisinin is used in the treatment of drug-resistant Plasmodium falciparum malaria. In China, Artemisia annua L., is a plant that was traditionally used as an antipyretic. The activity of this wormwood can be explained by the presence of the active substance artemisinin. Soon, artemether, artemotil, artenimol, artesunate and sodium artesunate, derivatives of artemisinin, have been developed. Each has its own physical and pharmaceutical properties, dosage and dosage forms.

The Swiss drugmaker supplies Coartem, whose main ingredient artemisinin is derived from the artemisia annua plant, on a not-for-profit basis to developing countries stricken by chronic malaria. A shortfall of artemisinin combined with resistance to older treatments such as chloroquine has hampered a global drive to halve deaths from the mosquito-born disease by 2010, prompting Novartis to boost its cultivation of the plant. The artemisia annua plant is native to China, but Novartis said it has teamed up with Kenya's East African Botanicals group to boost cultivation to more than 1,000 hectares in Kenya, Tanzania and Uganda. This will bring total production to some 10,000 hectares, Novartis said, spreading the risk posed by adverse weather and enabling the Swiss firm to provide more than 100 million malaria treatments by the end of 2006. Artemisinin -based treatments, such as Coartem, fight falciparum malaria, the deadliest form of the disease that causes as many as 400 million infections and at least a million deaths a year. The WHO gauges demand for Artemisinin -based treatments at some 130 million treatments in 2006. Novartis's Coartem drug would account for roughly two thirds of this quantity

[Kalahari Safari]

Hi Linda,

Thanks for the details, now I know what to go for and where to get it.
I have my daughter coming out from Switzerland in September and she will be able to get the hands on the test kit and the Coartem after all Novartis is in Basel.

Many thanks for the clarifications and back ground, I feel much more at ease now.
Walter

[Frank]

Why can we not get coartem and co-arinate in SA ? we travel a lot to Tanzania, and I have had malaria twice in the last 12 years, each time it has been hit on the head very quickly with the above mentioned and a course of doxycycline. The drivers of the overland trucks recommend it and they deal with malaria a lot amongst their clients. It is a herbal [artemesia] cure and is used extensively up north. Sandy [Frank's wife]

[MikeAG]

You can. I bought it over the counter at a chemist (I think you call it a pharmacy?) in Jo'burg.

[Frank]

Great to hear - shall stock up before our projected trip - have never been able to get it before down here in KZN

[mfuwefarmer]

Very expensive in SA compared to Zambia. Why not buy in Livingstone or Lusaka?

[Thirstie]

Here is the lastest. I left the contact details on if anyone wants to query.




Y ellow Fever vaccination NOT REQUIRED for travel between RSA and Zambia

20 July 2011

The South African Department of Health (DoH) informed tsi that there
is no change to the current policy regarding yellow fever vaccination
requirements for travel between RSA and Zambia. The Department of Health
would like to make it very clear that proof of yellow fever vaccination
is not a requirement for travel at RSA ports of entry or exit for
passengers from Zambia.

In order to best service your clients and passengers, stay up to date
with the current rulings and for the latest information available, please
refer to the Department of Health website ( www.doh.gov.za ).

If there are any changes to the policy, tsi (Tourism Safety
Initiative) will also inform all relevant stakeholders accordingly.



Kind regards

ANNELIE BARKEMA
tsi (Tourism Safety Initiative)
National Project Leader

fax +27 (0)86 686 2057
tel +27 (0)861 874 911
eMail [email protected]

[Kalahari Safari]

Thanks Linda,
.. just think where the hype has originated from, there seem to be conflicting rules circulating. Best is possibly to keep some reference to an official publication handy when crossing the border.

[mfuwefarmer]

We were never asked for YF, not at any border nor at JHB airport.
As I said before, wayback in 2001 they had the same "ruling" and it also turned out to be "a nothing"

[mfuwefarmer]

Thank you for your enquiry.
Please find herewith the official statement released on Friday 26-Aug-2011 by the Department of Health (DoH) for your perusal.
Zambia added to list of countries requiring Yellow Fever vaccination
26 August 2011
South Africans travelling to Zambia will now be required to have a Yellow Fever vaccination certificate following a global Yellow Fever risk assessment conducted by the World Health Organisation (WHO).
Zambia`s status has been classified as a low risk. However, as Yellow Fever is vaccine preventable, and travellers to and from countries with a low risk of transmission still risk contracting or importing Yellow Fever into South Africa, the Department of Health in South Africa has updated the Yellow Fever vaccination policy to include Zambia.
The new policy will be effective from 1 October 2011. From this date, a valid Yellow Fever certificate will be required for travellers over 1 year old:
· travelling from Zambia, or
· having been in transit through a Yellow Fever risk country including Zambia.
Yellow Fever is an infectious vector-borne disease that is caused by a virus. It is transmitted by the bite of an infected mosquito vector.
source: http://www.doh.gov.za/show.php?id=3047

Kind regards
ANNELIE BARKEMA
tsi (Tourism Safety Initiative)
National Project Leader
tel +27 (0) 861 874 911
fax +27 (0) 86 686 2057
eMail [email protected]