Malaria in Lamu and Serengeti

Some sites say areas in Ethiopia and Djibouti were a malaria risk. But after travelling to these places there didn't seem to be any risk.

I am puzzled. How were you able to determine that there was no risk?

I would not say that there is "conflicting information" about malaria risk in Lamu. All of the expert sites that I've consulted say that there is risk o malaria everywhere in Kenya below 2500m elevation and the city of Nairobi. That includes Lamu.

For what it is worth, I have never used anti malarial's anywhere in Africa. I have travelled globally to many very remote malaria ridden areas and the same applies. I just use the common sense approach which means not sitting around outside for extended periods of time in the early morning around sunrise or at sunset. If I did so, it would be with long trousers and shoes/socks so the mossies dont bite around my ankles which is common. You can also apply mosquito repellants. In my opinion this is far better than ingesting these anti malarial tablets. However, I agree that this is my personal course of action and some may feel that the risk of malaria requires the use of tablets and that is each persons choice.
Oh and yes there are mossies in the Serengeti also

Malaria is endemic on the Kenyan Coast, Lamu is no exception

I wasn't able to exactly say there was no risk.

But all the locals and other travellers said there was risk. I didn't get Malaria. I pretty much saw no mosquitos.

I have to agree with RogerAfrica. Malaria is obviously a serious problem in Africa but in my opinion using your common sense is the most important precaution. Use lots of insect repellant at sunset and try to wear long sleeves in the late afternoon.
Also notice that a small percentage of the mosquitos can transmit malaria and in most cases, it is a rather small illness comparable with the flu. Make sure you can identify the symptoms of malaria and act directly in case of sickness.

But also I agree that everyone has to decide for themselves whether to take the tablets. Malarone is probably the best option but very expensive. Lariam is the cheaper option but can cause some serious side effects.

Thanks for the opinions on medications and the risk situation in Lamu.
Malarone is too expensive and not available where I am.
Really don't want to take Larium.
Has anyone had Doxy and had a bad reaction to the sun?

But all the locals and other travellers said there was risk.

One thing you have to consider (besides my signature) is something called "partial immunity." People who live in a malaria area, especially those who grow up there, often develop this. Assuming they survive the first few bouts, subsequent cases are likely to be mild or even symptomless. This can lead local people to declare that malaria is not a problem.

Malaria in parts of Ethiopia can be in epidemics rather than a continual risk. Between epidemics, when malaria is at very low levels, local people may also feel that there is no malaria.

Has anyone had Doxy and had a bad reaction to the sun?

The most reliable study I've looked at said that about 3% of users found the photosensitivity so serious that they had to stop using it. Another study, unrelated to malaria, said that about 30% of users had problems, but the study did not say how severe it was. Based on what I've seen anecdotally, I'd say that 30% sounds about right. Most people cope with hats and lots of sunscreen.

I've only seen a couple of reports here of people who found the sun sensitivity so bad they had to quit.

I've seen more reports of people who had to stop taking it due to heartburn & upset stomach issues.

Hi,

There is very little difference in effectiveness between Malarone and doxycycline. The vast majority of people experience no side effects with either drug, but side effects with Malarone are slightly more common than with doxy.

According to the medical experts the potential photo-sensitivity side effect of doxy is rare, my own experience is in line with this, I have known many people who have used doxy (I've used it myself for periods of up to 6 months at a time) and I have only known one person have this reaction.

It is not related to skin colour or tanning / burning it is more like an allergic reaction to sunlight (phototoxicity) resulting in a rash of small blisters.

Some studies show the risk to be dose dependent, the higher the dose of doxy the higher the chance of phototoxic rash. The dosage for malaria prophylaxis is much lower than the dosage for many of the other treatments that doxy is prescribed for.

As said above doxy has the added bonus of also being a treatment for stomach bugs. One significant difference is that you have to continue the treatment for 28 days after your holiday.

Side effects are also fairly rare with malarone, some people complain about upset stomachs, my personal view is that upset stomachs are more likely caused by other things such as heat, alcohol, change of diet both quantity and content, recreational water illness, etc but people blame the ant-malarial.

Both treatments should be taken with food, with Malarone it is best taken with dairy food so breakfast is a good time. If you are taking doxy take it with or after food and make sure you take it while standing or sitting upright and don't lie down in the minutes after taking it. (this is because it can cause heartburn if it dissolves in the oesophagus rather than the stomach)

It only takes one bite from one mosquito to give you malaria. Is it worth it?

Also I have a very close friend from Kenya, whod'd lived there all her life until she was 18, who returned home after a year in the UK and was bitten and ended up in hospital needing treatment for malaria, so 'natural immunity' is a very personal matter and shouldn't be considered as a safe manner of protection for those who don't live permanently in Kenya.

Do yourself a favour. Bite the bullet. Pay up and swallow your tablet. You'll have peace of mind and a malaria-free holiday even if you acquire a couple of bites as souvenirs.