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Malaria

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cathyb
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Re: Malaria

Unread postby cathyb » Mon Sep 19, 2011 1:13 pm

Hi CarlaLo

I can't speak to increased risk between the north and the south, but a friend of ours contracted malaria in Punda when we visited last December

Hope this helps

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Re: Malaria

Unread postby onewithnature » Mon Sep 19, 2011 1:36 pm

CarlaLo, this might not be what you want to hear but:

The recommendations are that no pregnant woman should put her unborn foetus at risk by entering a high-risk (or even low-risk) malarial area, In other words, if you don't have to go to such an area, DON'T!

The reason for this is that, should you contract malaria, both the disease and the medications used for treating the disease, can harm your child. If I was pregnant - and that is one of the most unlikely events in the universe :wink: - I would not risk it at all. If you had to contract malaria and your baby was harmed as a result, you would never forgive yourself!

The WHOLE of Kruger - from north to south, east to west, southwest to north-east, northwest to south-east - all of the Park is officially a high-risk malarial area from the beginning of October to the end of May. There are slight variations in risk - based on rainfall, heat, the amount of water and/or stagnant pools close by, and other factors - but the risk is universally high throughout Kruger over this time.

Mid-October may still be a lower risk than later in the summer, but this depends mainly on the rainfall, and it is unlikely that rain will not have fallen by then. If you chose to go into Kruger in mid-October, you would be shouldering the responsibility entirely for your foetus.

What you COULD CONSIDER DOING is to stay outside the Park in a suitable area, and then commute daily into the Park. Some areas, relatively close to Kruger, are low-risk areas all year round (such as Hazyview, White River, Nelspruit, Thohoyandou) and the official recommendations are non-drug measures without the official need for antimalarial drugs. However, remember that you are pregnant, so a low-risk area does not mean a no-risk area!

Other areas, such as Sabie and Pilgrim's Rest, have such a low risk of contracting malaria to be deemed non-risk malarial areas. You could stay in a non-risk malarial area during the night and commute to Kruger in the day.

The reason for your relative safety from contracting malaria in such areas is that the female anopheles mosquito - which carries the malaria (the male is useless in this regard :wink: ) - only bites from dusk until dawn, with a peak-biting range usually between dusk and midnight, and again from about an hour before dawn until sunrise.

Therefore, if you were in Kruger between sunrise and a little before dusk, the female anopheles mosquito is not yet active. As long as you drive back to your non-malarial area from Kruger with windows up (that is if it is after dusk), then you should be almost entirely safe from contracting the disease.

[The only times that people who live in a non-malarial area really contract the disease is if a female anopheles mosquito is trapped in their car, clothing, or bags when they entered a malarial area, and she both is a carrier of malaria (not all mosquitoes do) and she bites and infects you. Therefore, these last events appear to be very rare.]



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.
Last edited by onewithnature on Tue Sep 20, 2011 6:11 pm, edited 1 time in total.
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Re: Epilepsy and anti-malaria medication

Unread postby chillx » Tue Sep 20, 2011 1:00 pm

Hi

Just thought I would give an update as I know it can be frustrating when people come on to a forum and ask questions then disappear.

In the end we decided to go with Doxycycline and I am pleased to say that none of us including my son who has epilepsy had side effects (there were 4 adults in the party). We returned from a fantastic trip to South Africa on Friday and will continue to take doxy for a further 3 weeks.

I do appreciate that everyone is different however I just wanted to share our experience.

We only saw 2 mosquitos so I do believe it was low risk however I think it is better to be safe than sorry. We used DEET spray in the evening and also wore long trousers, sock and shoes. It was really warm at night which we did not expect and were thankful for the AC.

We stayed in Berg en Dal, Skukuza, Orpen and Oliphants - accommodayion was a little rundown (not much change in the 26 years since we last visited). I felt there was a real apathy with regards to housekeeping. New bed linen wouldn't go a miss. It has to be said that compared to private lodges the rest camps are very affordable and therefore attractive when travelling on a budget. I would certainly use again.

We saw the "Big 5" which was fantastic; we did not think we were going to see a leopard however on our last morning as we were leaving oliphants a leopard crossed the road in front of us; it was amazing! It then disappeared into the bush; there wasn't anyone else on the road we were so lucky.

Thanks again for this forum and all the advice.

Chillx

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Re: Malaria

Unread postby saraf » Tue Sep 20, 2011 1:28 pm

FRUITBAT wrote:Hi OWN, please can you give me some advice with regards to my recent query :
Thanks very much

Hello forumites, my adult son is epileptic and we plan to take him to Kruger next February, however, I've always read that people taking anti-convulsants can't take anti-malaria meds. Obviously the risk of contracting malaria in the summer is much higher so am therefore worried. Would be interested to hear from any other forumites who have this same condition and what they do in this case.



Fruitbat, this post might help.
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Upset Stomach with Malarone

Unread postby AndreaB » Tue Sep 20, 2011 5:30 pm

The first time I took Malarone I had no problems but the second time early this year when we visited Kruger was an absolute disaster. I took it in the evenings to give it time to work through my system but still spent most of our precious time in Kruger racing between toilets. :? The stomach cramps were horrendous and there genuinely were times when I would have risked getting eaten to be able to relieve myself. I now read about Doxycyline, does anybody know about upset stomach side effects with this drug? I really cant bear to ruin another holiday like the last one.

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Re: Upset Stomach with Malarone

Unread postby Flutterby » Tue Sep 20, 2011 5:35 pm

What about taking a valoid at the same time...might help?
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Re: Upset Stomach with Malarone

Unread postby DuQues » Tue Sep 20, 2011 6:16 pm

I used Doxy, and on two occasions left my breakfast (just coffee, can't eat anything early) at the roadside.
Otherwise no problem, aside from the fact that you get sunburned quicker, so take precautions for that.
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Re: Epilepsy and anti-malaria medication

Unread postby onewithnature » Tue Sep 20, 2011 6:21 pm

Epilepsy, epileptic medication, and antimalarial medications are different for each case, and therefore each patient should be assessed separately. There are epileptic medications that are dependent on therapeutic blood levels in order to be effective (and often, if the levels move outside these boundaries, the patient fits), and one then has to be particularly careful with the type of antimalarial used, and indeed if antimalarials should be used at all. Then there are a specific set of trigger factors peculiar to each person that need to be taken into account. Some people are fine on certain antimalarials, some are not. Hence you will notice that I do not blanket-recommend on a public site like this. Some people have sent me pm's and, where appropriate, I have given my personal advice, based in knowledge and experience. However, always consult a knowledgeable health-professional who knows how to assess epilepsy (or any disease, really) in relation to malaria risk and antimalarials.
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Re: Epilepsy and anti-malaria medication

Unread postby onewithnature » Tue Sep 20, 2011 6:23 pm

Thanks for the update Chillx and glad that you all had a wonderful trip. :thumbs_up: :thumbs_up:
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Re: Malaria

Unread postby CarlaLo » Tue Sep 20, 2011 6:24 pm

Thanks for the info onewithnature!

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Re: Malaria

Unread postby onewithnature » Tue Sep 20, 2011 6:25 pm

You're welcome, CarlaLo. Hope it assists your decision-making. :thumbs_up:
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Re: Malaria

Unread postby onewithnature » Tue Sep 20, 2011 6:27 pm

FRUITBAT wrote:Hi OWN, please can you give me some advice with regards to my recent query :
Thanks very much

Hello forumites, my adult son is epileptic and we plan to take him to Kruger next February, however, I've always read that people taking anti-convulsants can't take anti-malaria meds. Obviously the risk of contracting malaria in the summer is much higher so am therefore worried. Would be interested to hear from any other forumites who have this same condition and what they do in this case.




Epilepsy, epileptic medication, and antimalarial medications are different for each case, and therefore each patient should be assessed separately. There are epileptic medications that are dependent on therapeutic blood levels in order to be effective (and often, if the levels move outside these boundaries, the patient fits), and one then has to be particularly careful with the type of antimalarial used, and indeed if antimalarials should be used at all. Then there are a specific set of trigger factors peculiar to each person that need to be taken into account. Some people are fine on certain antimalarials, some are not. Hence you will notice that I do not blanket-recommend on a public site like this. Some people have sent me pm's and, where appropriate, I have given my personal advice, based in knowledge and experience. However, always consult a knowledgeable health-professional who knows how to assess epilepsy (or any disease, really) in relation to malaria risk and antimalarials.

With regards to Fruitbat, I have pm'ed her some suggestions, and hope it assists her to make a sound decision. :thumbs_up:
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Re: Upset Stomach with Malarone

Unread postby saraf » Tue Sep 20, 2011 6:45 pm

I've had the same thing so I now take Doxy. Downside you have to take it for longer and have to use a sunblock as it increases sensitivity to the sun. Upside is, its much cheaper.

However I have just reread the Malarone instructions and it says not to lie down within an hour of taking it so that may be a cause of the stomach upset?
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Re: Upset Stomach with Malarone

Unread postby H. erectus » Tue Sep 20, 2011 7:16 pm

Reads very awful this thread!!

Does to me cause,- " protection",
seems a killer itself!!!
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Re: Upset Stomach with Malarone

Unread postby AndreaB » Tue Sep 20, 2011 7:58 pm

Without wishing to be too graphic my problem wasnt nausea but rather the "other end of the spectrum" which was even worse so I am afraid anti-nausea tablets wont help. I have just been reading up on the alternatives to Malarone and it still seems to be the best of a bad bunch which isnt great news. The alternative is going without and using buckets of mosquito repellant and long sleeves and pants which is probably not the best idea but sounds way more attractive than spending 10 days doubled over....


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