TB,
You're right on about which doctors have the experience to offer advice...the local doctors in the area where the disease is more often prevalent.

Having said that, the use of prophaxis must be carefully considered...

For one, the prophalaxis efficacies are vary regionally due to the fact that the parasites have developed resistance to some of the prophalaxis in certain regions.
Also the prophalaxis and 'eraser' drugs such as Arthenam/Fansidar have effects that are possibly more disastarous than the malaria symptoms.

Threads with recommendations of usage based on a singular experience are dangerous...
http://www.horizonsunlimited.com/hub...reatment-22410

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edde
93 BMW K75s
www.motoedde.com

There are loads of sites where you can obtain this kind of information and I agree you'd be better off talking to a medical professional who has direct experience of treating Malaria (not neccessarily your GP).

My understanding is that any Anti-Malarial Drug can be used to treat the disease providing it's a different drug from what you're taking every day to stop getting the disease in the first place.

I find doxycycline to be the best drug for ease of use if nothing else. Larium is needed where the threat is high.

I have had 2 bouts of Malaria! The first one in 1994 nearly killed me (caught in Lagos Nigeria working at the airport) P. falciparum! It was the most horryfying thing to experience so far away from home. My employer (the UK government) flew out 2 specialists from London together with a shed load of equipment to save me. I spent 1 month in hospital in Lagos (not a pleasant place at the best of times).

Docsherlock is 100% correct in his appraisal above.

Whatever you do DON'T listen to all those pillocks out there (including on this forum) who will tell you not to bother with anti-malarials! You know the kinda idiot - it's all part of the adventure ect... I remember meeting a whole family in Banjul The Gambia a few years ago, they had flown out on a late deal without taking any knid of anti-malarial precautions! When I forcibly told them I just got a blank expression and was then told to mind my own business and piss off! I felt sorry for the young kids...

I'd contact the London Hospital for Tropical Diseases or somewhere similar...

The Hospital for Tropical Diseases is dedicated to the prevention, diagnosis and treatment of tropical diseases and travel related infections.

ABOVE ALL REMEMBER TO IGNORE THOSE IDIOTS WHO TELL YOU NOT TO BOTHER WITH ANTI-MALARIAL PRECAUTIONS!
Stay healthy and safe.

__________________
Triumph Bonneville 800 (2004), Yamaha XT600E (1999), Honda XBR500 (1986).

Personal opinions proffered within the forum on medication use is pointless.

We have no idea of the individual's medical history or the area he will be travelling to...he may be allergic to sulfur based drugs, etc....or the 'eraser' drugs once he leaves the malarial zone.


The existing malaria drugs although help mitigate the risk of malaria are not innocent in their side affects...which can be equally dangerous.

Lariam (mefloquine) Information

Malaria Information Page - The Travel Doctor


Bottom line, do your research and make an informed decision...this is not something to be lazy about. Also, if the individual chooses not to use a drug after researching the issue, its his choice/body. Respect it and don't call him an idiot for doing so.

...

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edde
93 BMW K75s
www.motoedde.com

Hi Motoedde and Kentfallen,

thank you. Very good links.

It was new to me that prophylaxis like Malarone can be taken for a year and others up to five years.

I have taken Malarone on a number of trips (up to 4 weeks) and never had side effects. In addition, I always took repellents like no-bite and put up mosquito nets. However, on every trip I did get the occasional mosquito bite.

On the upcoming trip to Congo et al., I will take Malarone, although it's for two months. I'd be keen to get hold of a pack of Arthenam in addition.

Kentfallen, from your experience in Lagos, what went wrong in the treatment (4 weeks hospital) ? Did you get it too late, or is it simply not sure that the medication will show a quick effect? Where did you catch the second one?

I would have thought that in places like Lagos, expatriates don't take prophylaxis (simply too long) but there exists a standard emergency medication in experienced expatriate clinics.


I've had scrub typhus (30% fatality rate) in Malaysia 15 years ago - and got cured in a great hospital in the capital. Got amoebia in Turkey about 25 years ago, sweated it out, but was put in quarantaine back in Europe.

I contracted Malaria after only working in Lagos Airport for only 6 weeks but before that I was in Luanda Angola. I was taking prophaxis - Doxycycline (which was being used by all my mates in Lagos because it was so easy and didn't have serious side-effects). Some idiots didn't take a thing and I heard deaths sometimes occured.

If you go to any hospital in West Africa during the rainy season, you will find all of them full up with locals suffering from Malaria. If the locals get it and die then we are at immense risk. I remember visiting Banjul's main hospital in July and the whole place was heaving with childran and women. It's terrible to see these local people so desperate.

My symptoms were classic - feverish attacks, shivering, shaking, influenza-like symptoms, tiredness etc. The strain of Malaria I caught caused the Mother of all Headaches, so bad I needed Morphine to control it! I fell into a coma for 4 days in the middle. But the serious problem was my ticker which went into Tacicardia (high rythem). Nothing they did helped not even stopping my heart and electric shock! I am told these problems were caused directly by the Malaria. My heart is now 100% Okay with no long term damage.

The actual attacks of malaria develop when the red blood corpuscles burst, releasing a mass of parasites into the blood. The attacks do not begin until a sufficient number of blood corpuscles have been infected with parasites.

It is rare that a Briton becomes entirely immune to malaria, because this requires repeated bites from malaria-carrying mosquitoes, practically every night for several years. In the worst affected areas, children who live to the age of five years become immune

In malignant malaria the illness may evolve with a number of complications:

• low blood pressure (hypotension)
  
  
• kidney failure
  
  
• possible haemorrhage (bleeding)
  
  
• effects on the liver (eg infectious jaundice)
  
  
• shock and coma may also develop
  
  
• the condition may prove fatal.

If I were travelling into the bush where medical help was a long way off I would always ensure I had the means to treat Malaria. You need 2 drugs - one to avoid getting it and another to treat the disease if you get it.

The second time was in Banjul, Gambia and this time it wasn't so serious. A few days in bed with fever and I was as good as new. I suppose I now have a limited degree of resisitance but who knows?

__________________
Triumph Bonneville 800 (2004), Yamaha XT600E (1999), Honda XBR500 (1986).

Sorry to hear about the severity of your Malaria attack in Lagos! Good that you could beat it completely and maybe have resistance.

And you got it despite doxycycline prophylaxis !!! This is very useful information. I feel confirmed that one should always take along some malarial cure (at least in addition) when going in the bush.

I understand what you mean with the suffering of the locals.

Years ago I was in Kenya without taking any Malaria prophylaxis. Befriended some young Massai guys. They told me that THEY still get it, " and everytime it feels like dying".

Ever since, I have taken prophylaxis - and avoided getting bitten.

Doxycycline is not a real prophylaxis but it is basically a diluted antibiotic. It seems to have some effect but it would surely not be my first choice. The best stuff is still Lariam, provided you are not allergic to it (the depression stories) and subject to the area you are visiting. I took Lariam continuously for more than 12 months (whole of Africa), no problems whatsoever.

Even Malarone is not allowed to be used for more than 3 months, due to lack of testing data.

Cheers,
Noel