Good Afternoon.
I was w hoping people could comment on the vaccinations I plan on receiving before I depart for a 3-7 month extended stay in Ghana. Please reccomend any other that you have taken during your extended stay in Ghana.
Hep A
Hep B
Typhoid
Yellow Fever
Also,
I will be based out of Cape Coast. Does being in this area affect the anti-malarial I should be taking?
Is there a preferred anti-malarial for extended stays of 5 months or more?
First, I'm going to refer you to the US CDC's Health Information for Travelers to Ghana. Read the whole page; there's lots of useful info about health in general.
Then, to the UK Health Protection Agency's Guidelines for malaria prevention in travellers from the United Kingdom. Scroll down to "Chapter 7 - Special Categories." That has a whole section on long-term travel & expats. A bit technical.
Mefloquine (Lariam, Mefliam, Mephaquin), doxycycline and Malarone are all effective throughout Ghana for preventing malaria. There are pros & cons to each one. One issue for a long trip is availability and cost. Malarone is the most expensive and you will not be able to get it in West Africa. Doxycycline is the cheapest and is widely available. Mefloquine is in the middle--I have heard that yo have to hunt around a bit to find it in West Africa.
In terms of which one you should take, here is my usual mantra: There is no single best antimalarial. The best one is the one that is best for you, considering your destination, your health history, your allergies, your age, your gender, and, sometimes, your pocketbook. There are pros and cons to all the effective antimalarials. Someone else's experience cannot be used to predict how you will respond ot a given drug.
It's something you really need to discuss with your own doctor.
Hepatitis A is always a great idea. It is spread thorough fecal contamination of food & drink and you have no control over who has been handling your food and how meticulous they are about handwashing.
Hepatitis B is spread by body fluid contamination. There are other issues for Hep B besides getting, um, very well acquainted with local people. It can be spread if you have to get medical or dental treatment and the provider isn't meticulous about sterilization. Some people get it if they will be going to a country where the blood supply is not screened for Hep B, just in case.
You can get He A & B separately or in a combined vaccine.
Typhoid is always a good idea. It can be hard to diagnose and there is a lot of drug resistance. There are two vaccines available in the US--a shot, good for 2 years and an oral vaccine good for 5 years. (You may hear about a combined typhoid/hep A vaccine. It is not available in the US.)
You should absolutely be up-to-date on polio. If you have not had a booster as an adult, you should get one. Thanks to the polio problems in Nigeria, there are sporadic cases all over West Africa.
Meningitis See this thread. Meningitis Outbreaks in West Africa. Even if you will be based in Cape Coast, there is a good chance you will do some personal travel or meet someone who has meningitis.
Ghana requires a yellow fever certificate of all travelers.
No one, even a total couch potato, should be without up-to-date tetanus immunization.
Where to get the shots:
This is really if cost is an issue for you. If your insurance or HMO fully covers travel medicine, then you are OK.
EVen if your insurance does not cover travel medicine, it may cover hepatitis A&B or meningitis. It should definitely cover polio & tetanus.
The cheapest place to find a travel clinic is usually your city or county health department. Not all health departments do travel shots, but if yours doesn't, they may be able to refer you to one that does. There are a couple of ways to find out. Look in the government section of the white pages. You want something like "Public Health" or "Human Health." "Environmental Health" is hazmat and restaurant inspections & the like. Look for an immunization, vaccination or communicable disease unit and call them.
Get yourself a full medical & dental check up before going, so you can take care of any problems in the US.
Be sure that you have good travel health insurance. Whatever insurance you have now in the US probably will not cover you in Ghana. In some places, you cannot get treatment unless you can guarantee payment in advance. Be sure the policy includes medical evacuation. If you are seriously injured in the middle of nowhere, you may need to be evacuated to a big city or even to a different country for treatment. Without evacuation insurance, you and your broken pelvis may find yourself in a bumping taxi for hours.
Take a look at the list of recommended vaccinations for Ghana on the Centers for Disease Control website. There are several others in addition to the ones you mentioned.
I'm going to be in Ghana for a month later this year. In addition to Hep, Typhoid and Yellow Fever, I got vaccinated for meningitis and tetanus. Meningitis can be transmitted the same way as a cold, and it can be fatal. Ghana is in the Africa meningitis belt. Tetanus is a good idea if you haven't had one in the last five years.
Yes, not all hospitals are stocked with meningitis serum, for example, so it's best to get it before you leave home. Also, since there are so many myths about malaria, I want to mention that none of the preventative drugs are fail-safe. I've known people to get malaria on all of the ones mentioned in the posts above (me included). You just have to stick to taking them, as prescribed, and hope you don't get it. If you do, however, it's one of the easiest things to treat because it is so common--everyone knows how to deal with it; just make sure you tell someone early after symptoms appear and you'll be fine.
Good luck.
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