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odds on getting malaria without taking tablets

Posted by sdl68 on 15/8/2009 at 06:05

This from a Canadian travel health website

Retrospective studies of large numbers of travellers have provided an approximation of malaria risk during a 1-month stay without chemoprophylaxis: Oceania (PNG, Papua [Irian Jaya], Solomon Islands and Vanuatu) 1:30 or higher, subSaharan Africa 1:50, Indian subcontinent 1:250, Southeast Asia 1:1,000, South America 1:2,500 and Central America 1:10,000. It is noteworthy that the highest risk areas for malaria are Oceania, Africa and, to a lesser extent, the Indian subcontinent.

The odds are quite high because western travellers have no immunity whatsoever, although there are alot of expat travellers who dont take as many precautions because they think they do....Considering reported Dengue fever cases in SE asia are at least double malaria I guess one could conclude your odds of getting dengue are about 1:500

If anyone has found any other "odds" id be interested.

#1 sdl68 has been a member since 16/7/2009. Posts: 14

Posted by SBE on 15/8/2009 at 07:17

The odds in low season last year were about 1:5 amongst the people at resorts in the Togians in Central Sulawesi. While I was staying there 4 out of about 25 westerners had or had recently had malaria. One Indonesian staff member as well (that I know of).

#2 SBE has been a member since 14/4/2008. Location: Global Village. Posts: 2,019
 Where has SBE been? 


Posted by jgusa on 15/8/2009 at 08:12

From the brochure that Travellers Health Services(run by Alberta Health Services) gave to me in Edmonton, Alberta a few months ago.

"It is estimated that 1 million Canadians travel to malaria risk areas each year and this results in 300-1000 cases. Of these cases, 1-2 people will die each year.(The number of malaria cases may be even higher since many cases go unreported.)".

Although it doesn't specify the percentage of people who (don't) take tablets.

#3 jgusa has been a member since 26/5/2009. Posts: 1

Posted by Nokka on 17/8/2009 at 20:35

The link below is from the World Health Organisation. It shows the number of cases of malaria throughout the region by country; confirmed cases and deaths.

The totals for some countries in the region seem relativly small, with higher figures for Laos and Cambodia. Obviously this is for the population as a whole, not just tourists. Having said that, it always seems to me that tourists (ie me) seem to get bitten a lot more than locals.

I like stats; they allow you to weigh up the risk much better than someone on a forum saying you should or shouldn't take tablets.

http://www.wpro.who.int/sites/mvp/data/malaria/2007.htm

#4 Nokka has been a member since 6/4/2009. Location: United Kingdom. Posts: 259

Posted by SBE on 17/8/2009 at 21:14

Problem with the WHO is they get their stats from hospitals etc. Most people self treat and never (or can't) get to a hospital. When I lived in Africa, people rarely (even in the expat community) went to see a doctor about something as banal as a wee bout of malaria. About as newsworthy as a dose of flu in winter in the UK. Take a larger dose of the pills and sweat it out was what most people did. You only went to see the doctor about it if you or your family thought you were dying from falciparum...even then I had one doctor make it clear he did not want to be got out of bed in the middle of the night for someone showing severe cerebral malarial symptoms. How things work on the ground and what the WHO says are two different things.

Did you know that the WHO only discovered a bad malarial hotspot in the hills on the Cambodian border a couple of years ago? This is because the condition of the road means it's totally cut off during the rainy season. 60% of the local population suffers from malaria. No one can get there and the villagers can't get to a hospital either so no stats for the WHO. This recent discovery may have warped their statistics a bit about how much risk a tourist faces. The villages in the Cardamom mountains are not a major tourist haunt methinks.

Large-scale malaria survey in Cambodia: Novel insights on species distribution and risk factors 2007.

http://malariajournal.com/content/6/1/37

#5 SBE has been a member since 14/4/2008. Location: Global Village. Posts: 2,019
 Where has SBE been? 

Posted by BruceMoon on 18/8/2009 at 06:52

sdl68

There is a wonderful phrase, attributed to several luminaries, "Lies, damned lies, and statistics".

One of the problems of attributing a statistical approach to malaria incidence relative to traveller numbers by country, is that it doesn't really say anything.

In Cambodia, for example, the statistical relationship between traveller numbers and malaria - for those travellers that fly into Phnom Penh, stay a while, travel to Siem Reap, stay a while, and fly out - maybe millions to one.

However, for those travellers visiting Pailin (in nw Cambodia), the odds may transpire to be something like 1:30.

Sure, we need statistics to keep track of (potential) risk issues. But, it would be helpful if the statistical variables were fashioned in a way that exposed actual risk, not highlighted that a statistical measure has merely been taken for some meaningless report.

Cheers

#6 BruceMoon has been a member since 27/12/2008. Location: Australia. Posts: 1,941

Posted by Nokka on 18/8/2009 at 16:40

Benjamin Disraeli, I believe.

The problem here is trying to find any reliable information about the areas through which we may travel. I agree that there will be huge statistical variations between regions within countries, but, despite searching, can find nothing.

In addition, I can find no information at all about where, for example, British people returning home with malaria have been. There is a suggestion that the majority who contract the disease overseas have done so in sub-saharan Africa, but that's it. No information that I can find on how many Brits contracted malaria in Cambodia last year, for example.


For many, I suspect, the whole thing leaves us confused as what best to do.

#7 Nokka has been a member since 6/4/2009. Location: United Kingdom. Posts: 259

Posted by grasshopper322 on 3/1/2010 at 04:57

I debated on whether or not to pretreat for malaria and decided not to - many of my friends have traveled extensively in SE Asia, not pretreated and did not get malaria. The side effects of the medication would have made me so miserable so decided to take a chance - and did well. I did take a 2 month supply of medication in case I did contract malaria - I would have treated myself until I could get to a medical facility.

#8 grasshopper322 has been a member since 30/9/2009. Posts: 25

Posted by MADMAC on 9/1/2010 at 12:38

Again, it really depends on where you are, as pointed out in a few posts here. Where I live there is no malaria. We are not in a malarial zone. But we are in a dengue zone. Dengue is a risk here, but there is no prophylaxis.

#9 MADMAC has been a member since 6/6/2009. Posts: 6,957

Posted by patrickien on 14/1/2010 at 07:36

Hi,madmac,
Not sure where you live !! but do you have any idea of the conditions in Cambodia in March ? I'm traveling low budget ( 5-10$ guesthouses)with my wife and intend to do a round trip taking in Koh Kong along the coast then up to kratie and Sen Monorom and via Seam Reap /Battambang back to Bangkok, my wife usally gets bitten on arrival and tends to get an allergic reaction where the bites take a couple of weeks to clear up.
Will be taking malarone with us, but are wondering whether its worth taking an mossie net as well ?? Seeing as its the hot season maybe the mossies will be taking it easy or maybe there even more aggresive ?? who knows ?? all replies and advice would be welcome

#10 patrickien has been a member since 21/7/2009. Location: Netherlands. Posts: 23

Posted by tatham on 25/5/2010 at 19:12

I have had to think long and hard about whether to take the tablets or not, and have finally decided that I am going to take Doxycycline when I go travelling through SEA for 4 months during the wet season. It takes just one bite (and then odds go out the window). Although you need to get treatment anyway, I think it gives you a better window of time to get proper treatment at a quality clinic if you are on the tablets.

That said, it I react really badly to the tablets then I'll probably cease taking them and just keep them in supply if I do start to get symptoms. I have friends who have taken these specific tablets and they said that as long as taken with a hearty breakfast, you don't actually feel anything. But then again, it is on a case-by-case basis I guess...

#11 tatham has been a member since 10/5/2010. Location: South Africa. Posts: 8

Posted by Patcorbs on 11/5/2012 at 10:32

This thread has been dead for two years but for anyone still looking, here's a link to the most accurate and detailed study on the odds of contracting malaria I could find: http://www.malariajournal.com/content/8/1/296

#12 Patcorbs has been a member since 11/5/2012. Posts: 1

Posted by MADMAC on 12/5/2012 at 00:41

Patrick I live in Thailand.

You might want to PM Rasheed. He lives in Cambodia. Or Sayadian.

#13 MADMAC has been a member since 6/6/2009. Posts: 6,957


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