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Anti-malaria tablets, I need help!

Posted by torilou on 10/6/2010 at 15:44

My boyfriend and I are travelling from Bangkok Airport to the Aranyaprathet border, to Siem Reap, Phnom Penh, down to Kep and back, then through to Vietnam, around the South, and then back to Bangkok.

I've read a lot of information and need to find out if its right that I should be taking Malarone? We have Chloroquine and Proguanil from a previous trip that didn't go to plan, and I had always though I'd take those, but apparently there is some resistance to Chloroquine in parts of the aforementioned countries?

I need help!

Tori

#1 torilou has been a member since 6/6/2010. Posts: 25

Posted by SBE on 11/6/2010 at 00:52

There's chloroquine resistance almost everywhere in the world now and Cambodia has one of the worst multi-resistance problems in the world so it's definitely a waste of time taking it with you.

Malaria in Cambodia is mostly in very remote villages, not places tourists go. Malarone isn't really necessary but using mosquito repellents is....mainly because of the risk of catching dengue fever, not malaria.

If you REALLY want to take prophylaxis then an low cost alternative to Malarone is doxycycline, readily available in pharmacies locally and very cheap.

No reported resistance to doxycycline yet AFAIK but you have to take it regularly and according to the instructions. It's too slow acting to be used as a cure too.

The vast majority of expats and travellers with previous experience of SE Asia don't bother taking any anti-malarials. The only place I've ever actually seen tourists with malaria was in central Sulawesi (Indonesia).

#2 SBE has been a member since 14/4/2008. Location: Global Village. Posts: 2,002
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Posted by yogakhaolak on 11/6/2010 at 11:03

No need for Malaria tablets where you are going. All of those areas are pretty safe. As SBE mentioned, you only need it in very remote areas. And even then, the pills are not 100% effective.

#3 yogakhaolak has been a member since 1/4/2010. Posts: 45

Posted by duanea on 11/6/2010 at 21:03

Also Doxycycline makes your skin sensitive to the sun so you can get burned really easily!

#4 duanea has been a member since 2/5/2010. Posts: 4

Posted by SBE on 12/6/2010 at 05:07

Malarone and doxycycline as anti malarials compared.

http://www.welltravelledclinics.co.uk/leaflets/DoxycyclineandMalaroneProphylaxisV203.03.08.pdf

They say only 3% of people have problems with sun sensitivity and that a sunscreen can be used to prevent this. They also point out (in bold print) that no anti-malarial is 100% effective.


BTW Malarone needs to be taken at the same time of day and with some kind of dietary fat to be absorbed properly. Skimmed milk won't do (not that you can find fresh milk that easily in the tropics anyway)


I really wouldn't bother taking either drug ...if you do develop fever symptoms then you need to get a blood test to find out whether it is actually malaria. It's more likely to be dengue and there's no specific treatment or prevention for that. If it is malaria then you need to find out what type it is because the treatment isn't the same for all types.

#5 SBE has been a member since 14/4/2008. Location: Global Village. Posts: 2,002
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Posted by Turf on 13/6/2010 at 08:36

Having studied anti-malarials as part of my course, I would recommend taking them during your stay in Cambodia. Although the risk is minimal, it is better to be safe than sorry, as I have known of patients who have suffered from malaria, and it was not pleasant. As YogaKhaolak said, no anti malarials are 100% effective, and they're actually better at enabling the symptoms of Malaria to have a quicker onset, hence allowing quicker treatment.

In my opinion, you should go for Doxycycline, its cheap, works perfectly well, and has the similar side effects as Malarone etc (depends upon the patient). Only downside is that it reduces the efficacy of the contraceptive pill. So, the barrier method must be used. And if your in the UK, you'll have to contact your doctor to get it.

#6 Turf has been a member since 23/5/2010. Posts: 11

Posted by SBE on 13/6/2010 at 22:17

What course are you studying Turf?

I lived in Africa for many years and I've had malaria and so has everyone else in my family so I personally know what it's like.

We all took anti-malarials ... and we all caught malaria anyway.

My partner had undiagnosed falciparum for over six months and very nearly died... blood tests kept coming up negative until he stopped taking chloroquine. (At the time that was the WHO recommended drug for prophylaxis).

Are there any studies showing whether doxy or Malarone interfere with blood test diagnosis?

#7 SBE has been a member since 14/4/2008. Location: Global Village. Posts: 2,002
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Posted by sparkhog on 17/6/2010 at 03:12

Hi,

We're coming to Thailand in August for 3 weeks, Travelling to Bangkok > Ko Phangan, Ko Tao - maybe a bit of mainland, and possibly the Angkor Wat for 1-2 days. What do pepople think about taking malria tablets before and during? As the risk is apparently low. We may be going into the jungle a bit, in Phangan.

Regards,

Mark Williams

#8 sparkhog has been a member since 4/6/2010. Posts: 1


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