BootsnAll Travel Community

Irish,

Welcome to the boards. Malaria is indeed a hot topic, widely discussed on the boards.

It comes down to level of risk you are willing to accept in your life.

It is possible to get Malaria in the Mt. Kilimanjaro region. As this technical report on Malaria in Tanzania shows, the base region around Mt Kilimanjaro does reveal areas of high risk.
Donovan's wealth of experience in the area should also not be overlooked.

Ultimately you need to weigh the price of a few pills and some potential side effects versus the potential costs of infection.

quote:

Originally posted by irishpdx:

quote:

Originally posted by Donovan:
I have seen people on Kilimanjaro that are completely paranoid, anxious, and not comfortable being on the mountain whatsoever because of a mixture of Diamox (altitude), Malarone (malaria) and Ambien (sleep) and just arriving in Tanzania.

Anxiety, paranoia and hallucinations are potential side effects of mefloquine (Lariam) not Malarone. Some people experience extremely serious psychological disturbances from mefloquine and that's why you should probably do a trial run before you do something potentially dangerous like climb a mountain or scuba dive. Or take Malarone or doxycycline instead [emphasis added]

P. falciparum is not something to mess with and I have and will always take malaria tablets anytime it's recommended in Africa. And while it's true that most ex pats and all locals I've ever met in Africa don't take anti-malarials, self diagnosis and finding local treatment are not things that most short term travelers are up to coping with.

quote:

Originally posted by semicolon:
DOXYCYCLINEis an antibiotic that is effective in preventing malaria. I take a pill every day.

There's good advice here but take action under a doctor's supervision. I am allergic to doxycycline, and experienced major skin reactions before we realized their root cause.

A side note, are anti-malarials all antibiotics taken prophylactically? A trip to Kili would certainly seem an extenuating circumstance, but we should generally seek to minimize antibiotic use to prevent infectious diseases from getting too smart too fast.

quote:

Originally posted by SputnikLee:
There's good advice here but take action under a doctor's supervision.

It is difficult to find sounder advice regarding Malaria than this on the boards.

Well put Sputniklee.

If someone dresses up smart (full-sleeve shirt, and pants tucked into socks etc.) and sprays deet on all exposed parts, at regular intervals during the safari -- is it OK to avoid the tablets, alltogether. Is there anyone in here who got away by not using the tablets for say 3 weeks in Kenya, Tanzania and Uganda. I heard horror stories about Mefloquine (Larium). What are the side-effects of Chloroquine and Malarone? in general. I was told they are much safer.

S a i

http://mysite.verizon.net/koel/libya

Here is a link to a document about Malarone:

http://us.gsk.com/products/assets/us_malarone.pdf

Check out page 11, table 4, study 1. It compares the side effects between Malarone and Mefloquine. Study 2 compares it to Chloroquine.

But the CDC notes a Chloroquine "Resistance" for Tanzania.

http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?sect...=TZ&cssNav=browseoyb

Hi gang,

My son and I took Lariam as recommended by the Travel Nurse when we prepared for our trip in 04.
Two doses per day for seven day prier to departure.
The nightmares started two days in...
My son didn't want to get on the airplane in Detroit even though we knew it was the Lariam side effects.
On our third day on the mountain hiking from Shira 1 to Moir Camp I was absolutein my conviction that our guides were conspiring to disqualify me from continuing.
Complete madness.
Hey, I'm a child of the 70's and I'd never once been paranoid...
The real irony was as Donovan said...no mosquitoes on the mountain.

If I went again, however, I would still protect myself but with something other than Lariam because we were not always on the mountain.

Yeah, I know what you mean. I can't take Lariam, but that means that I will not travel in regions where alternative protection is not available. People I know have died from falciparum malaria.

Covering up and spraying DEET is not sufficient. Always seek out proper medical advice before embarking on a trip to malaria risk areas.

Hello

Malarone and Chloroquine (+ proganuil) - I think those are the two most commonly prescribed in the UK, but both have such a long list of side effects and can cause long term damage to kidneys etc.

Lots of people take them without any serious side effects. I have taken Chloroquine in the past and I felt fine. And recently my partner took Malarone but unfortunately it didn't suit him and he felt awful - nausea, flu like symptoms etc.

As Donovan so rightly said, there won't be any of the blood sucking little blighters on the mountain but Tanzania is a listed as a high risk country for malaria and is also resitant to the Chloroquine.

We're going out there in November and we will take Malarone with us. We are going to take every precaution possible to avoid being bitten in the first place, but if we do get bitten and do start to show any symptoms we will start taking the Malarone - there are different opinions on this, some people disagree and say that the drug should be taken as a preventative measure, however we don't want to risk taking the drug unless really necessary and will take it as a treatment rather than a preventative.

The best this is to seek advice on this from a doctor or pharmacist and then make your mind up from there.

There are lots of other stories about taking high doses of Vit. B and eating Marmite??? - I can't vouch for either of these, but hey, I'm gonna give it a go in November!

- Hope this helps.

Kelly x

Hi Kelly,

Welcome to the boards!

Definitely seek doctor's advice about taking treatment only. Personally, I believe in prevention being better than cure. Marmite/Vit B sounds too good to be true, although I'd take some Marmite anyway. It's amazing what you end up missing on the road

Some people (such as myself) always end up getting covered in mozzie-bites while others hardly ever get bitten. I wonder why that is.

quote:

Originally posted by semicolon:
DOXYCYCLINEis an antibiotic that is effective in preventing malaria. I take a pill every day.

When I was in Africa (I went from Cape Town to Cairo overland) we had a couple of Aussies who were taking Doxy and a local Doctor (who trained in the US) said it WASN'T effective against Malaria. Another problem with Doxycycline is you're not supposed to be in the sun while you're taking it. As a consequence both of these girls would be very uncomfortable if they were in the sun more than a few minutes at a time. It's not easy to avoid the sun in Africa and no amount or strength of sun block makes a difference. Another guy on our trip was taking one of the recommended prophylactics and still contracted Malaria (we believe while we were in Malawi) but didn't exhibit symptoms until we were in Zanzibar (where he got food poisoning as well, poor guy, but at least we were staying in a hotel and he and his girl had already opted for a room WITH a shower and toiled). The doctor there said basically what the medicine does is give you 24 to 36 hours longer to get to a doctor before your brain in literally fried by your temperature. From what I saw this poor guy go through I wouldn't take any more risks than I had to. I took Larium and didn't have any problems and that was for almost 3 months.

quote:

Originally posted by acs:
When I was in Africa (I went from Cape Town to Cairo overland) we had a couple of Aussies who were taking Doxy and a local Doctor (who trained in the US) said it WASN'T effective against Malaria. Another problem with Doxycycline is you're not supposed to be in the sun while you're taking it.

Some individuals develop photosensitivity when taking Doxy, however not all do.

In regards to doxy not being effective, there are plenty of comparative trials out there that suggest it has a +90% protective efficacy when referring to P. falciparum. From memore it is less effective against the P. vivax strain.The biggest issue with doxy is that is a daily regimen, and one that must be adhered to in order to get the protective benefits.

An aquaintance of mine travelled to a high risk area with someone who was taking a malarial prophalactic, and told me of his horror story. I don't recall the drug, but from what I read hear, I wonder if it might have been Larium. I also don't know if it was paranoia that affected this person's actions, but I'm told that the drug caused a possibly psychotic state that led him to murder his hosts. Does anyone know anything about such severe side effects, and which drug they might be related to?

quote:

Originally posted by travel bug:
An aquaintance of mine travelled to a high risk area with someone who was taking a malarial prophalactic, and told me of his horror story. I don't recall the drug, but from what I read hear, I wonder if it might have been Larium. I also don't know if it was paranoia that affected this person's actions, but I'm told that the drug caused a possibly psychotic state that led him to murder his hosts. Does anyone know anything about such severe side effects, and which drug they might be related to?

This rings untrue. Must be a hoax I thought, but then I found this.

Ongoing lawsuits...medical data....an interesting read.

Of course ... best advice already given....consult your doctor.

I took Larium religiously last year for my trip to Kenya, Uganda and Rwanda. Yeah, I got malaria hardcore. I don't know what the deal is, maybe I was that 1% statistic of people who get it while they're on meds, but either way I'm convinced it doesn't really work all that well. Doxy may be a better choice, only because you take it every day and are less likely to forget. Either way, I met plenty of people out there who never took it and never got the sickness. Can't say I'm one of them.

My two cents on this:

1. Your best bet on avoiding malaria is not to get bitten in the first place, so use repellent of some kind, and wear long sleeves etc

2. I think I've met all types in Tanzania - people who've taken anti-malarials and still got malaria, people who haven't taken anything and been fine, and all other combinations. So there's no certain answer. My advice would be to take 'em, though.

3. Speak to your doctor or travel clinic for expert advice before you decide either way!

Good luck!

http://kilimanjaroblues.blogspot.com/