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He!

For the first time i will travel through Colombia this august. I'll fly from Bogota to Pereira, then from Cali to Santa Marta and finally from Riohacha back to Bogota. I would like to know if it is highly recommended to take malaria pills (i got malarone pills from the pharmacist in the Netherlands) in Riohacha. I've bought DEET and an impregnated mosquito net. I hear a lot of nasty side effects of malaria pills, so if it's not necessary i don't want to take them (i will be staying there for max 4 days and then fly back from Riohacha to Bogota), but internet says that there is a high risk of malaria in Riohacha.

I hope someone knows the place and can tell me whether or not to take those pills in Riohacha.

Kind regards!

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1

4 of the 19 deaths from malaria in Colombia for the last year for which I can find data were in Riohacha.

I would take the prophylaxis, as well as the usual preventive measures. If you find that you have nasty side effects, then you could obviously stop.

I have taken just about every malaria pill known off and on in the last 48 years without any negative side effects (that I have noticed, others may think otherwise...). Gin and tonic works too.

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2

There are three antimalarials that are effective in Colombia. Atovaquone/proguanil (Malarone, Malanil); mefloquine (Lariam, Mefiam, Tropicur); and doxycycline (Vibramycin & many other brands). The stories you have heard about side effects may have been about mefloquine.

Malarone has few reported side effects. Generally, fewer than 5 % of users have reported problems (in research studies, the same percentage as people taking a useless sugar pill that they thought was Malarone). The most common reported problems are stomach ache, nausea, and headache.

One thing that a lot of people don't know about Malarone is that for maximum effectiveness, it needs to be taken with something with fat in it, as fat helps you absorb the ingredients. Coffee with milker cream. A meal cooked with oil. Buttered toast. A gooey dessert.

Yes, there is risk of malaria in Riohacha. In fact, there is risk pretty much anywhere in Colombia below 1700 meters. One thing you need to consider--and only you & your doctor can do this--is whether you have some medical condition that mens that if you got malaria, it would be unusually serious.

Although it doesn't happen a lot in healthy adults, malaria can be rapidly fatal, sometimes within hours of the appearance of symptoms.

As for gin & tonic (yeas, I know you are just having fun here)--Gin & tonic is often jokingly recommended to prevent malaria, because tonic has (or used to have) the anti-malarial quinine in it.

Alas, the amount of quinine in tonic is pretty minuscule. If you look at the fine print on the bottle, you'll often find that it is contains "quinine flavor," not quinine itself.

Some people with too much time on their hands calculated how much tonic you would need to drink to prevent malaria--estimates range from 5 to 67 (!) liters a day. If you consume that as gin & tonic, as Uncle Cecil from the Straight Dope notes, malaria may well be the least of your problems.


Nutrax
The plural of anecdote is not data.
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3

I have always thought of G&T as the most effective placebo I can find.

Good point re malarone and fats.

I took Lariam for two years in Congo; some of my colleagues/friends had negative reaction - I didn't (although it might have been the G&T getting in the way of noticing).

The problem with the pills is the same with all of them: getting the damn mosquitoes to take them....

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4
In response to #2

Thanks for your helpfull reaction! I've read many bad experiences with the use of malarone as well, but i guess most people will share their experience with medicines when they had a bad experience with them. Different doctors said to me as well that malarone isn't that bad as the others and that only a bad stomach is a regular side effect. I'll probably choose to take the pills!

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5
In response to #1

Thanks for your helpful reaction! Good to hear that you've taken different pills for the last 48 years without negative side effects. And i didn't know about the fact that 4 of the 19 deaths from malaria were in Riohacha! Next to the pills i'll probably have a few Gin tonics as well ;-)

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6

I took Lariam once and it was awful, I went green and had a fever, in the UK it is no longer recommended.

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7

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