Complete Malaria Information for Kenya and South Africa

9/02/2010 - Optimized for Firefox 3.6.8

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"Malaria is an ancient disease probably originating in Africa. The malaria parasite (plasmodium) is transmitted by female Anopheles mosquitoes. ..." - mosquito.org See also Complete information about MOSQUITOES ONE OF MY TRAVEL DOCTORs DIS-AGREED WITH THESE PREVENTATIVE MEDICINES - CHECK WITH A TRAVEL DOCTOR ABOUT YOUR SPECIFIC TRAVEL VACCINATION NEEDS. COLORS to WEAR and to AVOID and Other Precautions AFRICA - Traveler's Health Information Travel Vaccinations MD Travel Health - Kenya - vaccinations, malaria, safety, and ... All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs. Malaria - mdtravelhealth One option for emergency malaria self-treatment is to take a combination of artemether and lumefantrine, marketed as Coartem in the United States and as Riamet in Europe. Malaria Tablets - Which To Take for a Safari Trip? Malaria - MedicineNet Malaria Info - FitForTravel.nhs.uk New Malaria Vaccine Initiative Aims to Stunt Parasite within Mosquitoes Mosquitoes Declare War on Mount Kenya

MALARIA in SOUTH AFRICA

Malaria occurs in limited areas in South Africa, mainly in the low altitude (below 1000m) areas of Limpopo, Mpumalanga and North Eastern KwaZuluNatal. Malaria is distinctly seasonal in South Africa, with the highest risk being during the wet summer months (October to May). Wear long sleeved clothing (preferably light colored), long trousers & socks. How To Avoid Malaria PROTECTING YOURSELF AGAINST MALARIA IS IMPERATIVE ON A TRIP TO SOUTHERN AFRICA Malaria in South Africa: Introduction and Advice -2006 - may be out-of-date??? sulfadoxinepyrimethamine & chloroquine can no longer be used as a single treatment. Both mefloquine (mefliam) & doxycycline REQUIRE Prescriptions. Malaria & anti-malaria tablets (prophylaxis) for South Africa - either mefloquine (mefliam) or doxycycline Guidelines For the Prevention of MALARIA in SOUTH AFRICA Health Information for South Africa - CDC Travelers' Health South Africa Malaria Risk Areas Malaria - Kruger - virtualtourist Malaria - traveldoctor NOTE - temporarily borrowed from THIS paper - while safari planning: "Efficacy and adverse reactions of recommended prophylactic regimens more on: Doxycycline A high percentage of travellers who take malaria chemoprophylaxis will report side-effects, the majority of which are mild and self-limiting. In general, the incidence of mild to moderate and serious adverse events is similar for mefloquine and the combination of proguanil and chloroquine. The rate of serious adverse reactions is in the order of 1:10 000 for both regimens. However, the types of adverse events differ. The combination of proguanil and chloroquine commonly causes gastrointestinal adverse events, and mefloquine appears to cause more disabling neuropsychiatric events. Travellers discontinue their drugs because of adverse events at a similar rate for all the recommended regimens. Mefloquine Mefloquine is active against P. falciparum parasites that are resistant to chloroquine and sulfadoxine-pyrimethamine and the other three plasmodial species that affect humans8. Weekly dosing should encourage compliance. It is recommended for use for up to 12 months but has been safely used for more than 2 years. Adverse effects associated with mefloquine include insomnia, strange dreams, mood changes, nausea, diarrhea and headache. These would usually be experienced within the first three weeks of medication and do not become worse in subsequent weeks of use. If they are not experienced during the first use of mefloquine they are unlikely to appear during subsequent use for prophylaxis. Severe neuropsychiatric reactions (psychosis, convulsions) are infrequent with prophylactic doses and occur in approximately 1/10 000 to 1/13 000 persons. The frequency of mild neuropsychiatric effects is probably much higher. These effects may be sufficiently severe for the individual to discontinue prophylaxis. To forestall this event it is suggested that when mefloquine is to be taken for the first time that prophylaxis should commence three weeks before exposure to malaria to enable a change to be made timeously to another drug should side effects occur. Rare cases of suicidal ideation and suicide have been reported, thought no relationship to mefloquine has been confirmed. There is inadequate experience of the safety of mefloquine taken during the first three months of pregnancy. It should not be used during this time but in the event of a pregnancy, available safety data does not support termination. Taking mefloquine while breastfeeding is not recommended because of lack of data. Mefloquine may cause spatial disorientation and lack of fine coordination and should not be used where fine coordination is required, e.g. for pilots, underwater diving. Doxycycline May cause an exaggerated sunburn reaction, which limits its usefulness in the tropics. Sunscreen is essential. For women, an antifungal medication should be included in the medical kit, in case of yeast infection. Doxycycline is effective against all four species of human malaria parasites and has comparable efficacy to mefloquine. Doxycycline also treats cholera. During cholera epidemics, 90 per cent of those who get ill would be okay if they drank large amounts of water. This drug affects bone formation during early life and should not be given during pregnancy, breast-feeding and the first eight years of life. Adverse effects including gastrointestinal symptoms and candida infection of the gut and vagina and may be severe enough to discontinue prophylaxis. Severe skin sensitivity to sun burn may develop, excessive exposure should be avoided and the use of sunscreen preparations is advised. Other rare symptoms include dizziness, headache and blurred vision. There is limited experience with long-term use of more than 4-6 months." Mefloquine. (weekly). Start at least one week before entering a malaria area. Doxycycline. (daily). Start one day before entering a malaria area. These regimes must be taken for FOUR weeks after leaving the malaria area.

KENYA - MALARIA in

Health Information for Kenya - CDC Travelers' Health KENYA - Chloroquine resistance very widespread.

HIGH RISK MALARIA COUNTRIES (at least part of the Country)

KENYA, Mozambique, Swaziland, Zair, Zambia SOUTH AFRICA - North east, low altitude areas of Mpumalanga and Northern Provinces, Northeast KwaZulu-Natal as far south as the Tugela river. Risk IS present in Kruger National Park. Zimbabwe - The Zambezi Valley.

Preferable regimen:

Doxycycline It is related to Tetracycline. The most common reported side effect is increased sun sensitivity so make sure you take all precautions to avoid sunburn. Mild nausea, vomiting, diarrhea, trouble swallowing, or vaginal yeast infection are some other possible side effects. doxycycline - anytestkits Malaria in South Africa: Introduction and Advice - South Africa The length of the regimen can have adverse effects on the digestive tract, however, which can be alleviated to some degree with probiotics like Inteflora. (NO that's silly - just take over the counter Acidophilus or Bifidus) OR Mefloquine = Lariam (mefloquine hydrochloride) = Mefaquin Side effects include headache, nausea, dizziness, difficulty sleeping, anxiety, paranoia, vivid dreams and visual disturbances. If you're worried about the side effects, it's a good idea to start taking the tablets more than a week prior to your safari to see if/how it will affect you. Mefloquine may have severe and permanent adverse side effects. It is known to cause severe depression, anxiety, paranoia, aggression, nightmares, insomnia, seizures, birth defects, peripheral motor-sensory neuropathy,[2] vestibular (balance) damage and central nervous system problems. For a complete list of adverse physical and psychological effects — including suicidal ideation — see the most recent product information. Central nervous system events occur in up to 25% of people taking Lariam, such as dizziness, headache, insomnia, and vivid dreams. OR MALARONE = is a combination of two drugs (atovaquone and proguanil HCI). It’s called Malanil in South Africa; both brands are manufactured by Glaxo Smith Kline. Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare. Malarone (Atovaquone and Proguanil Hcl) Drug Information Malarone Information from Drugs.com Atovaquone - Wikipedia Malaria in South Africa: Introduction and Advice

ALTERNATE REGIMEN

Chloroquine PLUS Proguanil - (limited protection)

MALARIA in other African Countries

Zimbabwe - Areas below 1,200 metres - November to June. All year long in the Zambezi Valley where Doxycycline, Mefloquine or Malarone are preferable. Risk is negligible in Harare and Bulawayo. Risk in parts of the country Some chloroquine resistance present: Botswana, Zimbabwe - Areas below 1,200 metres - November to June. All year long in the Zambezi Valley where Doxycycline, Mefloquine or Malarone are preferable. Risk is negligible in Harare and Bulawayo.