BootsnAll Travel Community

I'm leaving in August for a RTW trip:

Thailand-Laos-Cambodia-Vietnam-China-Mongolia-Russia-Greece-Kenya-Tanzania-Ghana-Venezuela-Brazil-Paraguay-Argentina-Chile-Peru-Equador (or something close to that)

The problem is this:

SEA: Lariam-resistant malaria in Thailand/Cambodia. We're going to the Cambodia borders and other mosquito places, so I'm planning on taking Malarone until I get towards the Laos and Vietnam border and changing over to Lariam. (I'm planning on taking 3 weeks worth of Lariam here in the states to see if I have any adverse reactions before I depart...) Does that seem right? (The problem is that you're only supposed to take Malarone for a max of 90 days, and I'll probably be in SEA from 100-120 days.)

AFRICA/SOME OF SOUTH AMERICA: My understanding is that Lariam is among the recommended drugs, so hopefully I'll be on that.

THE REST OF SOUTH AMERICA: According to the CDC, Chloroquine is the ONLY recommended medicine in Paraguay, Argentina, parts of Ecuador, etc. Anyone know why? Will Lariam or Malarone not work? What have people done in South American when possible wandering around in areas with different resistant strains of Malaria...?

(I know there are a lot of anti-anti-malarials who are on this forum, and I hear you, but I'm gonna take my chances with the medicines not with Malaria..)

From the knowledge you have already, it is quite possible that you've already reviewed available information on sites like www.cdc.gov/travel/regionalmalaria which has good info on treatment for different areas.
The rest of SA ? is probably much as you have found the Asian sit'n to be, different strains/resistance.

From your knowledge already, you may have consulted sites like www.cdc.gov/travel/regionalmalaria which has a good breakdown on treatments.
The rest of SA sit'n. is probably just an Asian different strains/resistance repeat.
If unable to satisfy yourself from above site or one such as www.traveldoctor.co.uk or .com if exists, then last resort would be to see a travel clinic doctor or one specialising in malaria/tropical diseases and no doubt get another spin on different strains and/or overlapping/continuation of different treatments.
My approach would be to minimise use based on risk area/season information per CDC.

Shit, what a mess, sorry my first post had completely disappeared halfway in and reposted unaware it had still posted

Thanks, gonorth. I've actually been studying those sites for a couple of weeks. This whole things feels like a sadistic logic game.

I think what I've decided is to definitely do the Malarone is the Lariam resistent areas. Then I'll do Lariam the rest of the time. There's only a small areas in SA that need Chloroquine only, and I'm thinking I'll just avoid that area, unless someone advises differently...

Any other thoughts?

I'd talk to a travel clinic about it - the CDC website is great for becoming informed but there's no substitute for talking to a health professional about these kinds of things. You'll probably need to see one anyway to get the prescriptions.

For what it's worth (probably not much), I'm definitely in the pro anti-malarials camp and rather than switch from Lariam to Malarone I went ahead and took my chances for the 2 weeks I was around the Thai/Cambodian border.

And you probably already know this, but just so you don't get sticker shock when you go to the pharmacy: Malarone will cost you $5-6 a pill and Lariam a little more. Your health insurance may pay for a 30 day supply, but after that it's all cash.

You may be able to buy the pills cheaper abroad, but Malarone is not licenced in Thailand. Also, there is a possibility of counterfeits. I got away with Doxycycline, which is much cheaper, but that may not be recommended for the countries you're travelling to. It's definitely enough to give you a headache!

It is a good idea to 'test-drive' the Lariam (even though it's expensive) because some people suffer spectacular side-effects (psychosis, anyone?)