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@ Floris Chathy

Side Effects always occur. Did you try Lariam? then you will know that these Side effeckts occuring from Malerone are low. And of Course everybody is different. So all Medication will have other effeckts.

To the Price Paludrine/Resuchin is not much cheaper. Malaria medication are always expensive.

Best Regards

This is not an easy topic to advise on, especially when there are children involved.

Based on our own experiences with our children ranging between 2 and 13, I can say that we have never taken medication before and we travel to Kruger about six times per year, including December. I have on more than occasion saw people that have taken medication, react violently to it and litterally have their holiday spoiled.

My experience also include living and working in more than 40 countries around Africa and in 20 years I have only contracted malaria twice (once in the Congo and once in Mozambique). Trust me when I say though that it is not pleasant, so it is really up to the individual.

My advise would be to apply repelant between dusk and dawn and you would be fine, as malaria mosquitoes are only active during dark. Recent studies have also shown that the period just before dusk is a high risk period. Dont ask me how they are able to establish this, but I received the information from our GP.

You will receive many conflicting opinions on this topic and although the risk is very low during the winter months, it remains your decision.

@ Bundi

I fully agree to your stattement . Everybody who take this medications will reackt in another way to it. Some have no Problems at all and the others will get the heavy load of side effeckts. Some medication can avoid malaria to a special level. But the Probability that you get Malaria is still. there If you get malaria with medication the threadment of this sickness will be difficult.

You will be much less likely to get malaria if you have taken a preventative and with the medication, you are likely to get it in a less severe form.
Remember it is a killer disease especially for children.
Consult a doctor.

I personanlly would not let the risk of getting Malaria left to chance. We always do what Kite and Elsa is advising = take the necessary precautions as advised by a medical doctor and be fully informed regarding the disease by obtaining the information from a reliable source.

During the malaria high season (September to April) I always take malaria prophylaxis. Because it is either hot, or wet, or both. The malaria mosquitoes like "hot and wet"

During the months of May (last part of), June, July and early August, I usually go without. However, it is wise to look at the reigning climate when you visit comes near. I remember one year, I think it was 2008 when it was still quite hot (maximum temp > 28 degrees) and wet in the Kruger early in June (my trip was scheduled for 3rd week of June). That year I did take prophylaxis.

This year I think there was some rain in June (I didn't check since I don't have a trip scheduled), but it is/was quite cold (in Kruger terms), so I would probably have gone without prophylaxis if I had a trip scheduled for this year's winter season.

I am coming out for 11 days in late August, staying all over the park in main camps and bushveld camps. I would not normally take anti-malarials and just use DEET and other usual prophylaxis but this time I am coming with my 9 month old daughter.

Does anyone have any suggestions? Our tropical diseases in the UK suggests chloroquin syrup, but I've just been reading that the KNP does not advocate this due to resistance. She obviously can't take tablets. My GP will no doubt only read the advice from the BNF (drugs book) which I have already covered as I'm a healthcare professional myself!!!

Help!! (she'll be weighing in at about 9kg then!). I have my baby-friendly tropical DEET already.

Sarah

Well but even the Doctors are discussing how usefull the Medicine against Malaria will be. Some say you will reduce the effeckt if infected other say that is nothing more the a Myth. in reality there is no difference.

You should forgett that, Igeststions of medicine play a part. are you going to take it regulary or not?
There for case studies are very difficult to take.

Best Regards

I have been going to Kruger since I was a small child. I have been every month of the year. I have never take any anti-malari tablets. Always use spray, mozzie mats / coils & cover up in summer.
Never contaracted Malaria.
It is up to you but personally I would not take them!

You go Jen! I totally agree.

Hi Sarah.

You don't say what type of health professional you are, but you say you have covered most of the options, and therefore presumably understand the medical and medicinal terms and appropriate information. This makes it easier.

The first recommendation for taking a young child into a malarial area is always to tell you not to. However - and no-one can make that decision but you - if you choose to, to facilitate a sage decision, it is worth remembering the following factors.

Kruger is still a relatively low-risk area in August. You also haven't told me what type of accommodation you're staying in, but if it in newer chalets, the mosquito netting most likely will still be intact (check it anyway), thereby lowering risk if you take other suitable precautions. The baby-friendly DEET spray is great to use, if she is able to.

The risk of malaria infection is from dusk until dawn, so make sure that you have her indoors then, cover her body as much as possible (it can be cold that time of the year, which assists in togging her up), and perhaps even consider letting her sleep beneath mosquito netting (just in case that stray infected mosquito bites her).

Personally, I wouldn't take such a young child into a malaria area. However, if you do, I would definitely consider chemoprophylaxis for her. You are correct that chloroquine is no longer recommended for chloroquine-resistant areas, which Kruger has become. It is not that she would get no cover at all, but the side-effects would outweigh the benefit, especially as only a low percentage of cover is now likely with the drug.

Therefore, for children, though there are several opinions on this, the drug of choice seems to be mefloquine (e.g. Lariam). It can be used from 5 kg upwards, but at the weight you anticipate your child to be at the time of visiting Kruger, it is a fine line between taking 1/8 tablet per week for a child of 5-9kg, or a 1/4 of a tablet per week from 10-19kg, as antimalarial prophylaxis. Let your doctor decide.

Atovaquone/proguanil combinations (e.g. Malorone) can be used for antimalarial prophylaxis in children too, but it is only suggested from 11kg upwards, probably because the manufacturers have insufficient information to recommend it below this weight. Malorone has paediatric tablets available, which facilitates ease of administration. Lariam tablets have to be broken and the suitable portion crushed for children.

Atovaquione/proguanil combinations have the advantage of being used for antimalarial prophylaxis from a day before entering a malarial area, and then continuously until seven days after exiting the malarial area (this is because it is the only malaria medication that targets both the liver and blood stages of malarial infection within the body). It is a daily dosage.

Mefloquine must be used from 2-3 weeks before entering the antimalarial area, every week extra spent in the area, and for 4-6 weeks after exiting the malarial area. It's dosage is weekly.

Anti-malarial tablets may be crushed and mixed with e.g. chocolate syrup, jam, cereal or bananas to mask the taste. Tablets, especially mefloquine, should be protected from sunlight and high humidity once they have been removed from the foil wrapper.

Side-effects of either medicine is both medicine-specific and sometimes patient-specific. Frequent side-effects of atovaquone/proguanil include nausea, vomiting, abdominal pain, and diarrhoea. Frequent side-effects of mefloquine include transient dizziness, diarrhoea, nausea, vivid dreams, nightmares, irritability, mood alterations, headache, and insomnia.

As you can see, there are many considerations to take into account, and you and your health professional and/or doctor will have to weigh everything up. There is also the consideration that, if a child gets malaria, the progression of the illness can become fatal quickly. In addition, children often suffer from colds and flus, and malaria symptoms often mimic these. Then there may be consequences to the side-effects of the medicines - for example, diarrhoea and vomiting van lead to rapid dehydration in children if not well managed.

Whatever decisions you aim at, good luck and I hope you make the right choices! If you do decide to come with your baby, I hope that you will have a good time and that everyone will remain well.

Hope this helps?

Regards,
OWN.


Disclaimer: My recommendations here - though based on some experience and some drug knowledge - are not absolute, and further consultation with suitable health-care professionals is suggested before a final decision is taken on whether to enter a malarial area, what prophylaxis to use, and any general factors and limitations that need to be taken into account. Furthermore, I only advise based on what information is given by the person(s) entering the malarial area, but I have no control on the information given to me, and so such information could possibly be incomplete or misleading.

I was advised years ago to not take the anti malaria medication by my doctor, due to the fact that I go to the Kruger every 4-6 weeks and I would have to be on the medication all the time. I spray, coils and cover up etc, and have been lucky, up till this January!
If you don't take the medication and you sneeze more than twice in the following weeks from your visit, go get yourself tested. Luckily I went to the hospital the morning I felt sick and it was sorted there and then.

Apparently the medication makes the re accurances later on less severe, which I can say makes you feel worse than the first time round.

If you going infrequently, take the pills.

Then again, it was January and the little feeders had to scrape off 3cm of tabbard just to get to my skin, so maximum respect to them, it couldn't have been easy to get me!

I really think that we must now let Eliz now decide for herself!!!

We can all say "I did" "I didn't"............. My doctor said etc!!!

I think that she has enough info to make an informed decision!!

@ Vgstephens

You are right! We will not find a base now. because you always have persons which say no doubt you have to take it other say don´t take. And Both sides have good arguments to use it or not. In the end all of us have to decide how much risk, either from the insects or side effeckts of the medication, they are willed to take.

The risk of getting malaria in winter is very low. In summer it isn't even high in KNP.

The risk of Malaria being serious, or even fatal in children under 20kg's is very high.

Make sure you take all the preventative measures for yourselves, and for the youngster,
And also give the youngster the anti malarials.

I never take, winter or summer, but am extremely over cautious with the amount of precautions I take
to avoid bites, and we always gave anti malarials to the kids till around 6 years old.