Malaria in Lamu and Serengeti

Hey all,

Upon doing research for Malaria in Afica. There seems to be conflicting reports.
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 will be travelling to Lamu in a few days and again there seems to be conflicting reports on the risk of Malaria in the area.

If anyone has been there recently or is there now some information would be helpful.
I'm not really that keen on taking unnecessary medications.

Also while I'm on the topic I will be travelling to the Serengeti for a safari after Lamu. So also any info on Malaria there would be a help.

Cheers.

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.

I have white Canadian winter skin, and I took doxy for 7 weeks and suffered no side effects what so ever. It is an antibiotic, as mentioned by Doffcocker, and as such has other benefits!! I did use a 30 spf sunscreen, although in a shamefully haphazard way! Personally, I would consider this right up there in importance as drinking bottled water. Why take the risk? Sunburn heals...

Edited by: franandbrian

Take the antimalarials it's just not worth the risk, malaria is not be be messed with. You're in the privileged sitution of being able to afford the drugs so take advantage of that. I've taken dox before I had vomiting and mouth ulcers. However I had but no food poisoning unlike my malarone taking friends! Some people find that when they get back home it becomes difficult to keep remembering to take the tablets for a month and they don't complete the course. My current prefernce is malarone (or malanil in Kenya) as only needs one week after and one day before so handy for spur of the moment trips up country. I've had no side-effects.

If you are travelling through Nairobi, or any major town, then most pharmacies will stock it at around Ksh180 a tablet, which a believe is cheaper than in europe so you can pick it up here. If you can afford to go to lamu and on safari then you can have your pick of drugs - as alsacienne above says 'Bite the bullet. Pay up'.

Please do take malaria medication when you are in places where it's prevalent. i do not only say that as a pharmacist, but also as someone who had an adventurous friend who also opted to not take these pills dying from malaria she got in ghana.
There is no way you can see what the risk is ... anywhere. Use the professional travel health sites to determine that, not your eyes. You don't work there as a doctor ... Do you?
Also one morepieco of advice: while you can get the malaria medication in kenya as well, it has been shown, there is a big problem with counterfight (wrong) medication ... Up to 40% of the medication you buy there does not include the right (or right amount of) medicine. It's also something you can't see for yourself.
I amalso travelling to kenya this summer. I will take the medication, and buying it at home.
Goid travels to you!