Hello all,
I know that most of you are not doctors and that you can´t give professional advice. That´s OK, because I´m interested in personal experiences and I´m not going to sue you if your suggestions don´t help me : )
If a person is going to stay in Africa for an extended amount of time, then it seems to me that buying the anti-malarials for the whole duration is not going to make sense. Can you all tell me what you have found are the best anti-malarial meds to take as emergency assistance if you have already contracted malaria? I understand, for example, that Kinga Freespirit had the option of doing this, once she got the disease, but refused. I might be wrong, but the main point is that I would like to know what is recommended if that does happen.
Thank you in advance for your help.
Bradwell
This has got to be up for an ABTT Award for the most ridiculous posting I've seen yet! You can all flame me, but for gods sake!
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<hr> If a person is going to stay in Africa for an extended amount of time, then it seems to me that buying the anti-malarials for the whole duration is not going to make sense.<hr></blockquote>
Why????
If you are stuck in the bush with no pharmacy for a few days and your head feels like it's going to explode; what are you going to do? Prevention is better than a cure, and as someone who had malaria (not cerebral thank god!) I think it's completely stupid to even think of going without.
Nutrax, over to you!
Kira
For uncomplicated cases of malaria falciparum, the medication of choice in East Africa (at least in Tanzania) at the moment seems to be Artesunate / Arinate.
I also used a version of Artesunate called Artemos when I got malaria in Ghana. It comes in a small package of clear yellow capsules and it works wonders for low grade cases of malaria. Even a low grade case of malaria is pretty horrible - worst headache of your life, slight fever/chills, vomiting and diarrhea for several hours, but you will still be able to walk and get out of bed. If it's worse than that, you will probably have a more serious case and then should consult a doctor for the best course of treatment. In any case, even if it's low grade malaria you should consult a doctor.
If you are indeed going to be long term in Africa, I suggest reading Guidelines for malaria prevention in travellers from the United Kingdom. . It includes a section on long term travel and expats.
There is a fair amount of information that indicates that mefloquine and doxycycline can be taken safely for years; there is not as much information on Malarone, but indications are it can be taken safely for a t least 6 months.
There are a number self-treatment options available to you. But you need to remember that self-treatment is really just meant to be a life-saving emergency measure until you can get to medical care. What you have may not be malaria, for instance. Or you may go downhill so rapidly that the usually available stuff doesn't work fast enough. (Although it is not common, malaria can be fatal within hours of the first symptoms appearing). You also need to have the malaria properly diagnosed. Two of the four species of malaria have a persistent liver stage. If you have one of them, you need a second drug to get rid of it. If you don't, it can flare up again in 6-12 months. So-called malaria detection kits have been found to be very unreliable unless the users have been fully trained in their use.
As for "what locals do," it's also important to know that people who grow up in malaria areas often develop what is called "partial immunity" to malaria. Assuming they survive the first few bouts as a child, subsequent bouts are likely to be mild or even symptomless. You the visitor don't have this--it can take 15 years or more of residence for people who arrive as adults to begin to be partially immune. As a result, local practitioners may not recognize your malaria symptoms because they are different than locals. And locally available drugs may be more effective in anyone who already has some immunity.
On to what can be done. You can bring with you a treatment dose of Malarone. If you are taking Malarone to prevent malaria, they you should use something else. You need to get this at home; it is only available in Africa in South Africa and Kenya. In both places you need a prescription.
The "Artesunate" and similar drugs mentioned can be very effective, with some caveats. There is a whole class of drugs called artemisinins that are derived from the plant Atremisia annua. In addition to artesunate, there are, artemether, arteether and dihydroartemisinin. There are a number of brands sold in Africa; it may be called "Chinese malaria medicine."
A couple of problems. Artemisinins do not get that persistent liver stage, so you still need to get a diagnosis to see if you need that second drug. WHO now recommends that artemisinins be used only in combination with another drug, to prevent malaria from becoming resistant to artemisinins. A combination of artemether plus lumefantrine is sold in Europe as Riamet and in Africa as CoArtem.
While I always recommend taking prophylaxis for holidays and travels, I do not agree with generalised statements like "You cannot take the risk" - Of course you can take the risk, it's yours, and many if not most long-term residents (say of more than a year) DO decide to take that risk.
Thank you for your input, especially Nutraxfornerves who went out of your way to answer my question so thoroughly. This is kind of you and I appreciate this information. If I may impose on you just a bit more, could you tell me if doxycyclene is available in the West African countries. I know that doxy is supposed to be preventative and not for treatment as my original post indicated, but I want to review all my options.
Stefo - tell me if you could, what happens to a majority of those long-termers? Do most of them they eventually get malaria? I just wanted to know what you think about their risk.
Thank you again,
Bradwell
Doxy is available in W.Africa, however look into using it as there is a degree of photo-sensitivity with the sun.
I have several friends living & working in Africa, east & west. The majority of which all took some form of anti-malarials for the first 6months of their stay there to build up their 'immune' system (think that might be the right terminology). To arrive in Africa without something could be dangerous.
Kira
Most of those long-termers, me included, got malaria at some stage - and recovered quickly with proper treatment. I know that it can be a lot worse and that malaria can be fatal, therefore I would never ever tell anyone not to take prophylaxis. But it's also wrong to deny the fact that in the vast majority of all cases malaria does not develop into the serious form when treated promptly, so imo it is a risk that you CAN decide to take.
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