Deep breaths and gritted teeth all round ;-p

@Docsherlock

"misinformation in your posts (roaming yak) is too dangerous to other travelers to ignore."

- Please make it clear what you consider misinformation.

"Carrying a treatment dose in case you develop symptoms is a risky strategy, not least because you might take it when you have, for example, dengue and then not have it when you get malaria."

- You mean we shouldn't travel with any sort of cure like Coartem?! Many places in Africa won't have it, or it will be fake, so having your own supply is vital I would suggest. The NHS suggests the same: Emergency Treatment of Malaria - Fit For Travel
Or we shouldn't rely solely on this strategy? I travelled with 3 boxes of Coartem assuming I would give at least one away along the way. Agreed, its hard to judge when camping in the bush what a fever actually is, and local labs can be rudimentary at best. But I would say definitely travel with some of your own.

"One can take the drugs for longer than you will likely be in any one area as a traveler with no problems."

- That seems to be a blanket assertion that "the drugs" will never cause any medical problems no matter how long you take them? This is certainly not the advice I got from the NHS before leaving. Malorone was considered a bit 'untested' in this area I seem to remember.

@Mark

"You said "None of the drugs prevent you from getting it, all they do is slow the symptoms down hopefully enough that you can get treatment. " This is not framed as a question--it's an assertion of fact, and it is not true. You may not like my calling this "masking symptoms," but that doesn't make your statement true."

Question: As Malorone is used as a treatment as well as the prevention, if a person was taking it for prevention, surely it would also help control/slow down the onset of fever/symptoms/Malaria in general? It provides some resistance?
The NHS says "The same antimalarial medicines used to prevent malaria can also be used to treat malaria" for example.
Malaria - Antimalarials - NHS Choices

If that is true, then to my untrained eye with my strange Kiwi logic, my statement seems to be true, but it was lazy to say "none of the drugs" as I don't know if this is true of them all.

"You said, "nothing will stop you from having Malaria anywhere near to 100%. Drug companies may claim otherwise!" You may consider this to mean something other than "Drug companies claim that their antimalarial formulation will prevent malaria 100% of the time...." but I don't."

- "anywhere near to" being the key phrase. Must be a cultural mismatch of language ;-)

"You said, "doctors will always say to take something...." I said, ""Not all doctors recommend taking antimalarials all of the time..." I said that because I've consulted doctors on more than one occasion who recommended not taking anti-malarials. The fact that you haven't had this experience does not mean that "doctors will always say to take something." Your statement is untrue."

- Agreed, it was a slightly lazy blanket statement. I was trying to convey that the default western medical opinion is that you should take drugs to prevent Malaria. This seems also to be the general consensus of posters here?

I offered my own opinion, which is to prevent bites, carry a cure and not take any drugs, which I stand behind as a valid option, especially for a long trip.

There may be cases where the likely risks and the side effects don't balance, but from my experience the discussions start off with 'what drug would be most suitable' rather than 'shall we discuss malaria' which to me is strongly implying you should take something, its just a question of what, hence my statement.

Anyway, lets hope we all end up in a hospital ward in Congo one day in a fever to discuss it further ;-p

Mate, I have simply offered some opinions, based on my education and professional experience. Please feel free to ignore or consider, as is your personal preference.

I can't really be bothered to get into an extensive discussion with you; if you search the forum you will find all my previous posts on malaria and I don't feel like re-typing any of them.

Good luck, ride safe.

DS

No worries, but perhaps best to avoid saying somebody is spreading dangerous misinformation if your not willing to discuss it with them ;-p

I think Mark Harf covered this pretty well in his previous extensive posts. Largely to do with not taking anti-malarials and the drugs masking the symptoms of malaria.

I would not travel through Africa without taking anti malarials.

It' would be pretty hard to wake up somewhere with malaria and know that you have 500 kms with hard offroad driving before you get to a place with a bed and clean water.

I have more or less carried a fellow biker to hospital, he was not able to walk when he wake up. Luckily this happened in a town. It took him almost a week before he was able to drive a bike at all. He would probably have been dead if he had traveled alone on a remote place.

On the other hand, if you follow the tarmac and stay in cities it might be an option to decide otherwise.

Was the fellow biker taking anything when he got Malaria? That would seem to be an important point in your posting ;-)

He was not taking anything.
In my (limited) experience the few who gets sick when eating pills get don't get sick that suddenly.

That was my impression as well - but I got jumped on when I said it on here, so watch out ;-p

At the end of they day this comes down to a personal assessment of risk to your health. By all means take a sounding here but you really should take professional medical advice.

For what worth my personal experience of living in Africa (much of the time in very remote locations) is as follows

1) I started on Lariam and had a very bad experience after scuba diving (I had no idea there was a specific risk)
2) Switched to Doxy which I took for 3 years with no side/ill effects
3) Met and worked with many ex pats/long term expats who took no meds but "took the muti". Malaria amongst them was an accepted consequence which made them (sometimes very) ill on a regular basis.
4) Worked with a group of locals several of whom lost children to malaria whilst I was there. Again an accepted consequence.

For me living in an area where malaria had an obvious impact and being 4-6 hours away from even basic medical care the downside of long term use of an antibiotic v. the consequences of getting malaria made it an easy decision.

However, I'm sure others would have taken a different view - as is their right.

In summary - it's your life, your decision but I'd encourage you to take some professional advice.

Look after your body....as you have NO WHERE ELSE TO LIVE !!!!!

__________________
....rather Die Living.....than Live Dying !
www.globetrekkers.net.au

When you get sick, you get sick.
Life decides. :-)