Hi
Next year i am spending 4 1/2 months in East africa travelling. I need to get malaria tablets but have been quoted £25 for 12 tablets - of Malarone which is very expensive i think? Are there any alternatives that people spending long periods of time in Malaria zones could take. I live in britain.
Thanks
Mefloquine (Lariam) is better suited for longer stays since it is only taken once a week as opposed to Malarone's once a day. It is known to have psychological side-effects in about 5% of cases (?? - not sure of the % but relatively low) so if you have not taken it before then you are advised to start 2weeks before and you contimue for 4w after leaving a malarial area. Cost is about £26 for 10 tablets - so for 4.5m say 25 tablets or about £65. NB you can only get them on private prescription.
Added to which you can get the generic form in Africa under the name Mephaquin ...
I pay 6.70€ for 4 in Cote d'Ivoire. Same as Lariam, does the job & as I've said, many, many times, I actually sleep better when I take them than when I don't!
Worth investigating! If you're worried about the side effects get one now & see if you have any problems, as #1 says, it's a small minority that have problems!
Kira
If you can't take Lariam, the other alternative is Doxy...not as ideal as you need to take it daily but its a lot cheaper than Malarone. I took it for 3 months in Africa, no side effects/problems - some people are more prone to sunburn with it though, and its an antibiotic so it can interfere with the pill, but on upside as an antibiotic, people often report less problems with dodgy stomachs and other potential upsets.
As Kira suggests, whatever you use its a good idea to trial it before you go as if you are in the minority that gets side effects you don't want that to ruin your trip!
Enjoy!
Mefloquine (Lariam, Mefliam, Mephaquin), doxycycline (Vibrmycin and many other brands) and atovaquone/proguanil (Malarone, Malanil) are all effective in East Africa. There are pros and cons to each one. All should be available in Nairobi; Malarone may not be available else where in Kenya & is not officially licensed in other East African countries. Chloroquine, alone or in combination with proguanil, is not effective. You can read about the pros & cons here from the UK NHS.
Malarone/Malanil officially requires a prescription in Kenya, but I have seen reports of people finding an obliging pharmacist. The cost isn't much different than in other countries. (Malanil is the same thing as Malarone; it's made in South Africa..) Occasionally, clinics or NGOs in other countries have a supply, but you cannot rely on this.
Doxycycline is by far the cheapest, however, fake and substandard stuff does turn up in East Africa. Usual advice is to buy it from a pharmacy in a large city, perhaps one associated with a hospital. If offered pills in bulk, ask to see the original container with an expiration date. Out-of-date doxy may not be effective; seriously out-of-date or deteriorated doxy can actually be toxic.
For more advice on preventing malaria, take a look at Guidelines for malaria prevention in travellers from the United Kingdom. Chapter 7, Section 7.11 is about long-term travel. It is a bit technical.
For a long term trip, it may be worth your while to spend the money to talk to a specialist in travel or tropical medicine, not just about malaria, but to be sure you also have all the necessary shots.
Anti-malarial tablets such as Mefloquine (made in Switzerland) ) cost much cheaper in those countries - though you should consult a doctor in the first place.
My experience:
Mefloquine or Lariam...it's not 100% effective.
When I was in Tanzania yrs ago...volunteering, we had volunteers that took Lariam and GOT Malaria.
The problem was that by taking this anti-malaria ( Lariam) the symptom were hidden, and when the person involved went to the clinic to get a Malaria test...she was already very ill.
Not to scare anyone...
I would take Malarone which I have heard is the most effective, even if expensive.
Believe me...getting Malaria is not fun...so go for the best.
Regardless of what youve heard, there is no a single anti-malarial of any form thats 100% effective - known so far.
In reality there is no anti-malarial tablet better than another. They are made of similar substances that act or react in a similar way, and reflect similar side-effects that rarely manifest in their majority. Preference for Mefloquine over other types of tablets (those currently on the market) is mainly for convenience – as its taken usually once a week.
Its easier to identify the symptoms once you have experienced them in the past. It`s not by reading books about them that one can easily identify them in time, which I believe sounds the case of your friend.