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Author Topic: What Malaria Pills to take when riding in Moz?  (Read 1703 times)

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Offline McFarlen

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What Malaria Pills to take when riding in Moz?
« on: November 16, 2011, 10:01:31 am »
Do you guys have any recommendations regarding Malaria pills for Mozambique?  I am going to ride a solo trip for 2 weeks through Moz and Zim following the Zambezi as much as possible.

I have heard of Mefliam, but hear the side effects can be quite extreme.  I don't care about hallucinations (heck that could even be fun :D) but any side effects that affect the balance could be very dangerous on a bike!

So if any of you guys have taken the pills which would you recommend?

Thanks

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Offline AgentK

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Re: What Malaria Pills to take when riding in Moz?
« Reply #1 on: November 16, 2011, 11:26:13 am »
    I used to live in Angola for 3 years and still travel to Congo, Gabon and Angola on regular basis.
    I used malaria pills initially, but because of the extended stay, doctors advised against prolonged use.
    Malaria pills are not 100% effective and tend to hide the symptoms of malaria if you contract it, thus resulting in a worse case of the illness.
    If you do not use malaria pills, symptoms are quite easily recognized and treatment is far easier and the disease can be stopped in its early stages.

    ALL the pills have side effects, most of which have not been identified, but I use Malanil on and off (see note at the end).

    Your first rule of malaria prevention is: DO NOT GET BITTEN!
    That means night time and requires:
    1. Long sleeves, always.
    2. DEET, the higher the better. Tabbard contains 19% (or close to it) DEET . Try getting something with 50% DEET or higher.
    3. If possible burn, citronella candles or lamps
    4. Sleep under a mosquito net.

    If you are able to follow these rules, then chances are you do not need malaria pills, BUT:
    Also, get a malaria test kit and emergency medication.
    My company provides a test kit with 3 test units and Coartem.
    From Wikipedia: Coartem is an effective and well-tolerated malaria treatment, providing cure rates of up to 97%, even in areas of multi-drug resistance.

    If however you still feel the need to use Malaria pills, Malarone is a one a day pill and has the least potential short-term side effects. It is however stupidly expensive! +-R30/pill.
    Lariam (Mefaquin) might be a one a week pill, but: Hello psychosis! We have had guys trying to walk off the helipad on offshore rigs due to the hallucinations Larium caused.

    As per  http://www.southafricalogue.com/travel-tips/malaria-in-south-africa-introduction-and-advice.html :

    Malarone is the first choice, being the drug which the malaria parasite (southern Africa strains) is the least resistant to, and having the least recorded side effects. Itís called Malanil in South Africa; both brands are manufactured by Glaxo Smith Kline. Begin the course 2-3 days before entering a malaria area, and end it seven days after leaving the area.
    Mefloquin, better known by its brand name, Larium, remains a popular anti-malaria prophylactic, and is the least expensive of the drugs. Itís physical and psychological side-effects, however, are fairly notorious, and some reports state that certain southern African malaria strains have become resistant to it.
    Doxycycline is an antibiotic proven to be effective against malaria. The length of the regimen can have adverse effects on the digestive tract, however, which can be alleviated to some degree with probiotics like Inteflora.
« Last Edit: November 16, 2011, 11:31:46 am by AgentK »
 

Offline McFarlen

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Re: What Malaria Pills to take when riding in Moz?
« Reply #2 on: November 16, 2011, 11:53:01 am »
Wow thanks AgentK!

That is some quality and condensed info.  How much does that test kits go for?  And do your company ship them as well?

I will try to get the Malanil pills.

Thanks for the info again man.

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Offline louisj

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Re: What Malaria Pills to take when riding in Moz?
« Reply #3 on: November 16, 2011, 01:38:55 pm »
Doxy also makes your skin sensitive to the sun
 

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Re: What Malaria Pills to take when riding in Moz?
« Reply #4 on: November 16, 2011, 02:18:03 pm »
Malaria symptoms take from 9-14 days approx to reveal themselves - depending on the strain, so you have a good chance of being back before you realize you might have it - if you feel flu like symptons then, get checked immediately, and tell the GP you have been in a Malaria area.

I always use the Do NOT GET BITTEN approach advocated by AgentK - always worked for me - I travelled in Malawi, Tanzania & Kenya for 5 months or so like thsi without contracting Malaria, and numerous times to Moz as well.

Perhaps I was lucky, but I dislike the side-effects of the drugs too much to take them.

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Offline Just_Plain_Dan

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Re: What Malaria Pills to take when riding in Moz?
« Reply #5 on: November 16, 2011, 02:29:56 pm »
    I used to live in Angola for 3 years and still travel to Congo, Gabon and Angola on regular basis.
    I used malaria pills initially, but because of the extended stay, doctors advised against prolonged use.
    Malaria pills are not 100% effective and
tend to hide the symptoms of malaria if you contract it, thus resulting in a worse case of the illness.
If you do not use malaria pills, symptoms are quite easily recognized and treatment is far easier and the disease can be stopped in its early stages.


ALL the pills have side effects, most of which have not been identified, but I use Malanil on and off (see note at the end).

Your first rule of malaria prevention is: DO NOT GET BITTEN!
That means night time and requires:
1. Long sleeves, always.
2. DEET, the higher the better. Tabbard contains 19% (or close to it) DEET . Try getting something with 50% DEET or higher.
3. If possible burn, citronella candles or lamps
4. Sleep under a mosquito net.

If you are able to follow these rules, then chances are you do not need malaria pills, BUT:
Also, get a malaria test kit and emergency medication.
My company provides a test kit with 3 test units and Coartem.
From Wikipedia: Coartem is an effective and well-tolerated malaria treatment, providing cure rates of up to 97%, even in areas of multi-drug resistance.

If however you still feel the need to use Malaria pills, Malarone is a one a day pill and has the least potential short-term side effects. It is however stupidly expensive! +-R30/pill.
Lariam (Mefaquin) might be a one a week pill, but: Hello psychosis! We have had guys trying to walk off the helipad on offshore rigs due to the hallucinations Larium caused.

As per  http://www.southafricalogue.com/travel-tips/malaria-in-south-africa-introduction-and-advice.html :

Malarone is the first choice, being the drug which the malaria parasite (southern Africa strains) is the least resistant to, and having the least recorded side effects. Itís called Malanil in South Africa; both brands are manufactured by Glaxo Smith Kline. Begin the course 2-3 days before entering a malaria area, and end it seven days after leaving the area.
Mefloquin, better known by its brand name, Larium, remains a popular anti-malaria prophylactic, and is the least expensive of the drugs. Itís physical and psychological side-effects, however, are fairly notorious, and some reports state that certain southern African malaria strains have become resistant to it.
Doxycycline is an antibiotic proven to be effective against malaria. The length of the regimen can have adverse effects on the digestive tract, however, which can be alleviated to some degree with probiotics like Inteflora.[/list]

Thats an old wives tale!!!
Malaria drugs does not hide the symptoms.
The symptoms appear later, that part is true, but it is because the parasite is only multiplying at a much much reduced rate than what it would have, have you not taken the prophylaxes.

So in effect you might only realize you have malaria 10 days after contracting malaria, but you will still only be 30% as sick as you would have been 10 days after contracting malaria without prophylaxes.

PS - I hope this makes sense, as my engrish is very deliciousness today!
« Last Edit: November 16, 2011, 02:31:36 pm by Just_Plain_Dan »
 

Offline lonerider

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Re: What Malaria Pills to take when riding in Moz?
« Reply #6 on: November 16, 2011, 04:46:50 pm »
Malanil / Malarone is hideously expensive.

I'd recommend Doxycycline - one a day, but make ABSOLUTELY sure you've eaten something solid before taking them. It's a (very) mild antibiotic, and has the least side effects. If you're worried about long-term use, make sure you eat some (natural) yoghurt and plenty of fibre and drink lots of water (which you'll likely be doing anyway).

You'll get plenty of advice saying not to bother with anti-malarial medication. Ask yourself: if you're going on a short (2-6 week) trip, is it worth the hassle, expense, and consequences not to try and protect yourself by a) using correct and thorough anti-mozzie protection, and b) taking some drugs for a short term that are proven to work against the malaria parasite breeding in your body?

(Also meant to say - worked contract in West Africa for four years - and chose to protect myself against malaria as much as possible.)

(If you choose not to take drugs - stupid decision IMO - then make absolutely sure you get to a doctor at the first sign of a splitting headache or flu-like symptoms. Don't "man it out", you could die. Any medical doctor in the bush will know what to do, so don't worry about getting to a first world clinic first. Get treated first, live to get home for "proper" attention.)
« Last Edit: November 16, 2011, 05:01:51 pm by lonerider »
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Offline Leo

Re: What Malaria Pills to take when riding in Moz?
« Reply #7 on: November 16, 2011, 04:53:28 pm »
Use active measures - long sleeves, citronella, etc rather than passive measure - pills, etc.  :thumleft:
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Offline imo

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Re: What Malaria Pills to take when riding in Moz?
« Reply #8 on: November 16, 2011, 05:15:05 pm »
have a bath every day with nothing but Citronella soap, all ways works for me.  Not exactly gonna pull the chicks though :)

Offline AgentK

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Re: What Malaria Pills to take when riding in Moz?
« Reply #9 on: November 17, 2011, 06:34:34 am »
    tend to hide the symptoms of malaria if you contract it, thus resulting in a worse case of the illness.
    If you do not use malaria pills, symptoms are quite easily recognized and treatment is far easier and the disease can be stopped in its early stages.



    Thats an old wives tale!!!
    Malaria drugs does not hide the symptoms.
    The symptoms appear later, that part is true, but it is because the parasite is only multiplying at a much much reduced rate than what it would have, have you not taken the prophylaxes.

    So in effect you might only realize you have malaria 10 days after contracting malaria, but you will still only be 30% as sick as you would have been 10 days after contracting malaria without prophylaxes.

    PS - I hope this makes sense, as my engrish is very deliciousness today!

    Well, yes. Maybe that was a bit presumptuous.
    Based more on my experience of colleagues contracting malaria and seeing the difference in recovery between those on pills and those going without.
    PLEASE NOTE: I am not say you should not take medication. It is just that prevention is the 1st line of defence. [/list]
     

    Offline shark_za

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #10 on: November 17, 2011, 06:45:38 am »
    When I used to do month long trip into Moz we never took preventative pills but got a small supply of Fansidar to keep in case someone got it.
    I have many doctor friends and I dont know if its even available anymore.

    Get the symptoms, pop the Fansidar and 3 days later you are 100's.
     

    Offline alanB

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #11 on: November 17, 2011, 07:29:09 am »
    For some reason the doctors often prescribe Larium or its generic derivative Mefliam.

    Personally I dont thing thats a good option it has psychotic type side effects - bad nightmares, depression, moodiness etc.  Why go on holiday and hate everyone you meet or travel with and generally be in a bad mood?

    A friend of mine's wife had a bad reaction to Larium and went into a coma and permanently lost the hearing in one ear.

    Plus I heard from someone in the medical industry its not the most effective drug against malaria anyway.

    I use Doxycylene myself, its cheap, and apparently effective, but you do need to eat before taking it.  But I dont always stick to the long period after you return when you are supposed to keep taking it.
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    Offline Just_Plain_Dan

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #12 on: November 17, 2011, 08:25:31 am »
    For some reason the doctors often prescribe Larium or its generic derivative Mefliam.

    Personally I dont thing thats a good option it has psychotic type side effects - bad nightmares, depression, moodiness etc.  Why go on holiday and hate everyone you meet or travel with and generally be in a bad mood?

    A friend of mine's wife had a bad reaction to Larium and went into a coma and permanently lost the hearing in one ear.

    Plus I heard from someone in the medical industry its not the most effective drug against malaria anyway.

    I use Doxycylene myself, its cheap, and apparently effective, but you do need to eat before taking it.  But I dont always stick to the long period after you return when you are supposed to keep taking it.

    Myself and my wife use mefliam, its cheap (R100 for 6 tablets) and you only have to take it once a week, not daily which makes it convenient.
    The psychotic type side effects is not a guarantee, neither of us has ever had any side effects. Not even a bad dream.
    So I think one should try the different types of meds to see which one works for you.

    First line of defence should obviously be not to get bitten, but thats not always easy.

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    Offline IDR

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #13 on: November 17, 2011, 09:03:29 am »
    I have a box of Malanil at home, expiring sometime soonish - can have it for free if you want.
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    Offline McFarlen

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #14 on: November 17, 2011, 09:38:36 am »
    I have a box of Malanil at home, expiring sometime soonish - can have it for free if you want.

    Hi IDR.  That would be much appreciated!  Can I have your email and then we can discuss how to sort it out. Or you can email me at albertkruger1982@gmail.com

    Thanks again mate.

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    Offline captain jack

    Re: What Malaria Pills to take when riding in Moz?
    « Reply #15 on: November 18, 2011, 11:27:50 am »
    i was at a talk given by the head of the national institute of communicable diseases a  month ago and she debunked the tale that the medication masks the symptoms. She said the problem is that people don't keep up with the regime once they get home, and once you forget a tablet or two you can develop malaria, but it tends to be a bit milder initially because of the medication.

    1) Prevention: most mosquito activity takes place at sunset and sunrise. Indoors and protected. Tabard tabard tabard tabard
    2) the femail mosquito is very quiet so you won't hear her and often you won't even feel the bite. People say oh but I wasn't bitten. They just aren't aware.
    3) Medication: As covered previously. Doxy seems the cheapest easiest, but laramil is super easy as only a week or so on your return (See point 1, this is where the problem comes in)
    4) I was surpised to hear that the mefloquin side effects are overated, well at least they number of people who actually have problems is very small.

    I was also amazed at how long you could take this stuff. For Doxy I think it was three years continuous and for Mef it was 2 years.

    It all depends on your risk profile at the end of the day. Indoors in an airconditioned hotel, significantly lower risk than camping! They also highly reccommended moz nets impregnated with pesticide.

    And if you are pregnant.... no no no no no!
     

    Offline Gunner53

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #16 on: November 24, 2011, 04:39:32 pm »
    Hi - what dates are you doing your trip. Doing Moz as well and also looking at the malaria issue
     

    Offline McFarlen

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #17 on: November 24, 2011, 07:35:14 pm »
    Hi - what dates are you doing your trip. Doing Moz as well and also looking at the malaria issue

    Hi Gunner.  I am leaving on the 1st of Dec.  Will be in Moz until the 7th if all goes well.

    Regarding the Malaria pills.  I took Agentk's advice and bought 2 boxes of Malanil.  They cost R1060 for 24 pills!!! I almost fell on my head.  But I suppose the amount will be cheaper than getting damn Malaria and then going for treatment.
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    Offline Beltzer

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #18 on: November 24, 2011, 09:54:10 pm »
    I met a Doctor in Tanzania that specialises in tropical diseases such as malaria a while back and basically what he said was that your symptoms might be hidden by medication and you will get sick but you will not die. When you don't take medicine you stand a change of dying. SO... I go to Malawi quite a lot so im on Mefliam permanently as im not yet ready to meet my Maker. And Im still waiting for the nice side effects, cant be a bad as LSD :) ) The permanent people that stay there takes doxy. We had 11 malaria cases in October along and not one of them took their medicine, this number, with the raining season coming in Malawi is bound to increase.


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    Offline laurika

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    Re: What Malaria Pills to take when riding in Moz?
    « Reply #19 on: November 25, 2011, 01:04:33 am »
    Malanil -R40 per day including 5 days before you leave, once a day while u there (same time of day) and 5 days after u back. I am a bit slack with the before and afters ! Its the onlly one that does not make me sick as a dog. Have to admit. When I work in east and west africa I take other. Precautions and skip thhe tablets, but in Moz I would not dare to.....

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