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 Post subject: Re: Malaria: To medicate or not to medicate
Unread postPosted: Wed Jul 06, 2011 3:23 pm 
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I had Malaria last year and it was the worst illness i ever had in my life (at the age of 31 i am still young but anyway). I couldn´t take any precautions as i stayed in Southern Africa for 6 months. Well...........i got Malaria in Mozambique - where the mosquitos are very vicious - and not in KNP. But as KNP is boardering Mozambique the mosquitos can´t be very different.

I got bitten only once at this time and it happened in May when there were less mosquitos around than in the summer. This means that one never can feel save and should always be aware of the mosquitos.

I wouldn´t give any advice to take precautions or not - it is always your own choice. Even if you are on precautions you still can get Malaria. The precautions only reduce the risk.

The best thing one can do is to avoid to get bitten. How to avoid to get bitten was widely descriped already.

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 Post subject: Re: Malaria: To medicate or not to medicate
Unread postPosted: Fri Jul 08, 2011 3:51 pm 
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Well said @ Andreas_79 :thumbs_up:

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 Post subject: Re: Malaria
Unread postPosted: Mon Aug 08, 2011 5:45 pm 
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Hello, I am visiting Kruger/Greater Kruger for 3 days during the first week of October. I am allergic to antibiotics, so when I went in for my travel medical consultation, the doctor prescribed Malarone instead of Doxy. However, she did warn that Malarone, though not technically an antibiotic, has similar mechanisms. So I hesitate to take it. Any thoughts on going to Kruger in early October without taking any drugs? I was originally planning on staying inside the park, but I'm now thinking I should stay somewhere with air-conditioning in Hazyview or Sabie and only drive into the park during the day. Is this a safer option? Are both options no good without the antimalarials? Thank you.


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 Post subject: Re: Malaria
Unread postPosted: Mon Aug 08, 2011 5:50 pm 
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Thank you for your first post on this forum, dcbee, and a very warm welcome!! :dance: :dance: :dance:

I'm off to work now, so I don't have time to respond fully, but I WILL get back to you in the morning with an answer. :thumbs_up:

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 Post subject: Re: Malaria
Unread postPosted: Mon Aug 08, 2011 7:17 pm 
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Welcome to the forums! Incidentally, you are member # 22.222! :bdaysmile:

I would really, really, really advise you not to stay outside the park! First of all it does not help, the mosquitos don't honour borders, and they are also (a little) active during the day.
Second, and most important, you would miss out big way.
You would have to cue at the gate, knowing that the people inside have been driving around seeing awesome sightings (or not) for an hour before your gate opens. At a busy gate that can easily become 2~3 hours!
And when you have to rush out of the park those same people will still be driving around. Mind you, in both cases with the best photographic light to boot.
Then there is the evening/night. The people at the fences may get visitors at the fence, like hyenas, leopard, bushbabies, you name it. You could hear roaring lions and such... Which you will not outside the gate, unless something went rather wrong.
You would not be able to talk/brag about your sightings to the neighbours in camp, while having a drink, waiting for your braai (BBQ) to become perfect.
Instead you would have to face civilisation, traffic jams, traffic lights, and possibly a poor hotel kitchen. If you burn your food on the braai at least it's your own fault.

In october I don't use anything against malaria, remember that Kruger has a low malaria risk. I just use DEET and dress up a bit in the evening, like wearing socks.
Many bungalows now have screened terraces (not my choice) and all are sprayed against mozzies.

I would stay in Kruger...

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 Post subject: Re: Malaria
Unread postPosted: Mon Aug 08, 2011 7:25 pm 
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Plus if its Air Conditioning you want then you don't have to go outside the park as most units have A/C.

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 Post subject: Re: Malaria
Unread postPosted: Tue Aug 09, 2011 10:28 am 
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Hi dcbee

It is highly unusual to be allergic to every class of antibiotics on the market, so I would wonder what classes you are indeed allergic to - the most common are penicillin and sulphonamides. Also, when you say you're allergic, what actually happens? In other words, do you swell up and have to be rushed to hospital, or is it just gastrointestinal discomfort or vomiting?

Remember that antibiotics are designed to kill the bacteria in one's system and do not kill human cells; the side-effects are a result of disturbances to human systems, such as an imbalance of "good bacteria" in the gut. Malarone (atovaquone with proguanil) also attacks foreign organisms, not human cells: it works by interfering with the growth of parasites in the red blood cells of the human body. Perhaps in that way it is similar, although it is a schizonticide and not an antibiotic.

Technically speaking, the beginning of October defines the boundary between low and high risk areas in seasonal malarial areas in South Africa. Therefore, October to May is considered high risk in Kruger and both the World Health Organisation and the South African Department of Health recommend the use of antimalarial tablets in addition to non-drug measures (antimalarial sprays, netting, citronella-oil products, long sleeves and trousers, etc.).

I say technically because there are other factors that affect the proliferation of mosquitoes, most especially the advent of the rainy season. If it is still dry and there is an obvious dearth of mosquitoes when I go to Kruger at the beginning of October, or the end of May, I tend to not use antimalarial tablets - although I always indulge in non-drug measures - but that is only what I do, and is not necessarily a recommendation for others, especially as the official guidelines state otherwise.

Ultimately, you need to decide what you want to do regarding taking antimalarial tablets or not. It depends on various personal factors too, which only you can consider and weigh up.

As to staying outside Kruger and doing day-trips in, I agree wholeheartedly with the others. I did it only once and I will not do it again in a great hurry! Stay in Kruger if you can - you will not be sorry from a game-viewing experience.

Though it is true that mosquitoes do not honour human geographical boundaries, one must remember that certain areas outside Kruger may not be diligent enough in spraying and controlling their mosquito populations on a regular basis. Kruger is indeed diligent (as far as I know) and most of their accommodation, in my experience, has netting, although some of the older accommodation may have not had the netting sufficiently repaired to prevent mosquitoes squeezing through. Nevertheless, I have seldom had problems with mosquitoes inside the accommodation - mostly, I get bitten outside between dusk and dawn - and, in summer, I further restrict mosquito access within units by keeping the air conditioning on.

There are indeed some places outside Kruger that are all-year-round low risk - such as Hazyview and Hoedspruit - but my choice, if I had yours, would still be to stay in Kruger and take suitable and sensible precautions against malaria infection. Remember that a low-risk does not mean no risk, although it IS lower than a high risk area.

Whatever you do, dcbee, enjoy your trip to the full!

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.

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 Post subject: Re: Malaria
Unread postPosted: Tue Aug 09, 2011 9:45 pm 
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The best advice when taking medication or not is to cover up thoroughly from dusk till dawn. Spray or rub creams behind necks, over and around ears, behind knees and the soft parts of the forearms and wrists. Take care


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 Post subject: Re: Malaria
Unread postPosted: Wed Aug 10, 2011 12:06 am 
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Ouma Biskuit wrote:
The best advice when taking medication or not is to cover up thoroughly from dusk till dawn. Spray or rub creams behind necks, over and around ears, behind knees and the soft parts of the forearms and wrists. Take care


Yes, and also apply suitable antimalarial sprays or creams on the ankles (where I get bitten most) and on the soft parts of the skin between the toes, and, if possible, a dab on the temples too. Avoid spraying them onto the face though - if I only have a spray, then I spray onto the palm and then apply to appropriate parts of the face and neck, avoiding the eyes and mouth.

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 Post subject: Re: Malaria
Unread postPosted: Wed Aug 10, 2011 5:27 pm 
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Hello, everyone! Thanks for all the input. You've convinced me to stay inside the park after all! :D

@OWN, I am allergic (very high fever + hives everywhere) to every class of antibiotics I've tried, which are amoxicilin, azythromycin, and sulpha drugs. So I guess technically I could still try another, but I'm not especially eager to...

I bought myself some 35% DEET lotion and insect repellent pants, shirts, and socks, so now I just have to figure out what to do about taking drugs.


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 Post subject: Re: Malaria
Unread postPosted: Wed Aug 10, 2011 5:58 pm 
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Not pleasant to be allergic to so many classes of antibiotics, and commonly used ones at that, dcbee. :( I understand your reticence to avoid any other classes. I do see, though, that you haven't mentioned the tetracyclines - not sure if you've ever used them - to which doxycycline would belong. Something certainly to consider, especially during the rainy seasons in summer, if you're visiting high-risk malarial areas. Otherwise the combination of atovaquone (an analogue of coenzyme Q10) and proguanil, or mefloquine (a synthetic analogue of quinine), should also hopefully be okay. Whenever you decide to use antimalarial medication, rather do a test run several weeks before you're planning to use them; just in case.

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.

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TR: NECTAREAN NICETIES OF THE NORTH
TR: PRIMEVAL PLEASURE

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 Post subject: Re: Malaria
Unread postPosted: Thu Sep 01, 2011 10:30 pm 
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Friends have just arrived today at Punda Maria. Luggage got lost (or delayed?) from Netherlands... they only have enough Malarone for a few days.

Is it possible to obtain Malarone anywhere north of Phalaborwa Gate... close as possible to the Park, and with a weekend coming up? I really don't know much about Thohoyando, is that an option????

(They also need contact lens fluid & cheap clothes for the lady)


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 Post subject: Malarone near Punda Maria?
Unread postPosted: Thu Sep 01, 2011 10:33 pm 
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Friends have just arrived today at Punda Maria. Luggage got lost (or delayed?) from Netherlands... they only have enough Malarone for a few days.

Is it possible to obtain Malarone anywhere north of Phalaborwa Gate... close as possible to the Park, and with a weekend coming up? I really don't know much about Thohoyando or Giyani, is either an option????

(They also need contact lens fluid & cheap clothes for the lady)

:(


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 Post subject: Re: Malarone near Punda Maria?
Unread postPosted: Thu Sep 01, 2011 10:55 pm 
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Malarone is not an over the counter medicine as far as I remember. So that may be a problem. However it is a small one unless they have medical reasons for wanting to use it. It's a low risk time, I would not be taking anything.

As for shopping Giyany is the nearest larger town. At 80 km from the gate. But I would not happily go there.
The park shop might have stuff, they can claim the cost at the airline anyway, but it might hit their travel budget a bit...

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 Post subject: Re: Malarone near Punda Maria?
Unread postPosted: Thu Sep 01, 2011 11:09 pm 
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Malarone is Malanil in ZA and is a prescription item. Try the park shop first. They normally keep anti malarial prophylactic but not malanil.

Advise to use peaceful sleep or tabard and avoid getteing mossie bites. It is low risk time and we have not had first rains yet but not advisable to tell them not to take anything as they may be high risk due to medical reasons as you point out.


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