I'm perplexed...so many - some more effective than others in certain areas... so I tought it'd be best to ask for personal experiences in using them.
It's now only three weeks (!) until I fly to India, where I'll be spending up to 6 months travelling around the sub continent, and Nepal etc. followed by 2 to 3 months in SE Asia (Thailand, Cambodia, Vietnam, Laos, Malaysia).
What are the best Anti Malarials for each area? Which ones do I need prescriptions for? Do I ave to use the same ones throughout the trip? Any information will be gratefully received!
I took the advice of some people, and got a prescription for Flagyl (sp.?) the other day, although hopefully I'll not need it!!
lol, Fair point - just though that with so many well travelled folks on this site, there may be some valuable personal opinions to throw into the cooking pot :)
Just having a look on the CDC website too (http://www.cdc.gov). Going to make an appointment with the doc too. At least I've had all my jabs now, anyway - my arm no longer feels like a dart board!
for a years travelling round africa in 89 i had nivequine twice weekly and paludrine twice daily but all through central african republic and zaire i had the runs(undigested pills coming from the bottom end) and not surprisingly by tanzania I had come down with the big M.6 nivequines 6hours later 4 nivs then 2 a day for a week will save youre life but you feel like shit! it recurred months later in botswana and i decided soon after to come home were having been in the uk for a few hours i ended up in the hospital for infectious diseases in london(i had malaria and salmunella food poisening) The moral of this story?get the best advice you can try and avoid the shits(hard in india)and take those pills because malaria is bloody awful.
You are best off going to a travel clinic. I am not sure if there is one at the london hospital of tropical diseases. I work next door at the London School of Hygient and TRpoical medicine and we have our own, but some of the local GP travel clinics are not always up to date. However, you should be at relatively low risk most of the time in India especially if not in the rainy season but parts of Thailand and Nepal are high risk adn have resistance. There is still very little resistance to mefloquine, otherwise known as Lariam. don't believe all that you hear about this. Most people take this with no problems at all (including me). You take it once a week and is extremely effective and safe to take for long periods. Take it 2 weeks before you go, if you are going to have any side effects, you will experience them in this period, then you can try something else. Malarone is the new but very expensive replacement, but this you have to take every day adn if you forget any, it does not give full protection, whereas if you have taken lariam for a month and then take one a few days late, your protection will still be very high. The best protection is to not get bitten as there are other equally nasty diseases you can get from biting things. Long sleeves etc, if pos take your own bed-net and Life systems 50% Spray % 20% Roll on are def the best -I speak from experience! Sometimes you can get lariam on prescription (depends on your area) otherwise you have to pay - aprox £60-70 for 6 months ( i think)
Sorry a bit long winded but thought people might find it useful
Obviously for safety check with specialists, but my extensive research for when I went to India 3 years ago was that for India and SE Asia Larium wasn't necessary, compared to Africa, as the strain of Malaria is less likely to kill you and levels of resistance to other drugs is lower (though rising).
On my first visit to India I took the Chloroquine/Paludrine (I may have got the names slightly wrong) combination, but I suffered an allergic reaction on my return, and it's not recommended for those with skin problems such as eczema).
For my second trip I took Doxycicline (again I'm not 100% on the spelling!) which I was very happy with. It's not licensed for malaria prevention in the UK (although my GP suggested it) but is in other countries, and the advantage is that it's also sometimes prescribed for upset stomachs and I didn't get the runs in four months there, so it may have been preventative.
I use Malarone, despite the cost (my GP hadn't heard of it either, but eventually agreed to a private prescription for me). You don't have to take it ages before or after you travel, and there are no bad side effects documented, as in the case of, e.g. Lariam.
When in remote areas, I also soak the cuffs and collar of long sleeved clothing in 100% deet (careful because it can discolour things) and use a 50% deet body spray.
A good site for further advice is www.masta.org.uk who will send you a detailed report for the area(s) you are visiting.
I have recently looked at lots of information because I am going to East Africa next week. I found this page very useful.
Although I read good things about Malarone, it will not be an option for you because you are going away for such a long time.
I would also agree with Sharon about Lariam - I think people have blown its side-effects out of proportion. I am not saying there aren't people that suffer severe side-effects with it, I am just saying you shouldn't be worried about trying it (assuming it is recommended). I expect many of the complaints are from people that don't take it properly - i.e. during/after a meal and with lots of liquid. (Again, I'm sure there are people that take it properly and still have problems). Personally, I have suffered no side effects at all after the two pills I have had so far (not even the trippy dreams some people get).
I know there has also been some press about American soldiers severe reactions to it, but I suspect this might be to do with the "one size fits all" approach used in the army. By that, I mean people that should not be using Lariam (e.g. prone to depression, epilepsy, etc) are given it anyway for the sake of uniformity.
