Malaria Tablet Questions

Hotstepper44

Wassup people, i wonder if anyone can help me.
I am off to goa in june for a year +
The info i have been given in regards to malaria tablets say i need to take 300mg of Chloroquine weekly and 200mg of proguanil daily for a week prior to flying to india and then for the duration of my stay.
This may sound silly but do they really mean for the whole duration of my stay?! This seems like a long time and i believe they arent the cheapest tablets either(£16 for a 14day supply). There must surely be a time when ur body starts to become more immune to malaria, does anyone know how long these tablets need to be taken for? I have also read prolonged use of chloroquine can lead to eye damage.
Any knowledgeable experience anyone can provide me in regards to these queries would be much appreciated.
Cheers

ba9rn

I believe most tablets should also be taken for a few weeks AFTER you return. There have been many posts about this (search for malaria) - my doctor recommended the 'bite avoidance' technique instead of any preventative medication. There are many schools of thought. Basically, as you say, there are side effects. Also, malaria is totally curable - so as long as the symptoms are recognised early (which should be OK as long as they know where you've been!) they can deal with it OK. my doc reckons it's better that way.

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the irish indian

Hi hotstepper,

If it was me i would definately take them over the monsoon period as this can be a high risk time. Also apply a mosi repellant containing DEET especially at Dawn and Dusk.

During the dry season I would tend to DEET it up and lay off the tablets but there has been an increase this year of tourists returning from Goa to UK with Malaria. Ask your GP for his advice and go by what he says, Be Safe not Sorry!

machadinha

<cross-posted>

I'd speak to your local travel health clinic, good idea for a year's stay anyway. Or just your doctor, preferably one who specializes in tropical diseases.

To my knowledge one doesn't become immune to malaria no, one either survives it or not, and a year isn't all that long to build up resistance to anything. It's true there are varying issues with long-term use of various anti-malarials, again, ask those folks about it, presumably they prescribed it to you anyway.

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SteamBuff

If your Doctor has advised taking them all the time, then I would.

You have to start 1 week before your go and stop 4 weeks after your return.

In the UK they are the cheapest.

Hotstepper44

great i cant wait to start taking them lol
Ok well thanks evry one for the advice

Dr. Gajaprishthakara

Hi Hot,

Suggest that you use the search function to see the range of different answers that you will receive. To answer a couple of bits (from my perspective) yes, they mean the whole period of your time in an effected area. In addition, Chloroquine should be started at least a week before arrival or before the beginning of the transmission season; proguanil should be started the day before. The drugs should be continued for 4 weeks after departure from the endemic area. The tablets are available in India at less than the cost you have indicated.

You will not build up an immunity to malaria during your time in Goa (only some people born in malaria areas may have a short-term immunity). The drug combination is recommended as safe to take for periods up to one year.

Note that while UK citizens traveling in India are recommended the drugs that you are inquiring about, US and Australian citizens are recommended
* atovaquone/proguanil, OR
* doxycycline, OR
* mefloquine, OR
* primaquine (in special circumstances).
(see http://www.cdc.gov/travel/regionalmalaria/indianrg.htm )

You are advised to read:
http://whqlibdoc.who.int/publication...0364_chap7.pdf
and
http://www.hpa.org.uk/cdph/issues/CD...(3)p180-99.pdf

Please note that I am not/not a Doctor of anything really useful like medicine. Seek your own advice and make your own decisions.(Sorry, when I started response, no one had responded - apologies for the bits that repeat other posters' advice).

edwardseco

Much cheaper in India..

mt.kailash

It's best to check with your GP esp for long term use.Also to establish the real facts.
eg Malaria is not curable ,and even if it was why get it in the first place since it can also be FATAL.
In my experience Proguanil is about the same price in India as in the UK-and Indian pharmacists may not be as fussy about storage rules,expiry dates, and provenance as UK chemists.
Chloroquinine is given away free in India - but it's very cheap so take your own for the above reasons.

cyberhippie

A couple of points.
Partial Immunity IS present in local people, but it takes a long long time to build this up. Also the locals are not immune to ALL Malaria but to particular strains. Indians often get Malaria too when struck by a different strain or whilst on holiday!

As edwardseco has pointed out drugs are much cheaper in India but the particular combination you speak of is hard to track down in India, A cheaper but just as effective way would be to use the antibiotic Doxycycline, which IS readily available in India and very very cheap!!

Nick-H

mt.kailash, until very recently I would have posted exactly the same --- but it seems wee are out of date!

Apparently it is possible to eradicate malaria from the system these days. It is very important that it is correctly diagnosed, and that the correct drugs are taken for the specified period to achieve this.

It seems that Malaria is no longer an illness that neec remain for the rest of one's life --- and I think this is one of the main reasons why advice to travellers to India is veering towards prevention/treatment rather than prophylaxis.

Strongly recommend this document as an excellent read on the subject. Its target audience is doctors who are advising travellers, so it is not too 'dumbed-down'; at the same time it is also not too technical for us mere mortals to understand!

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camelgirl

Excellent, thanks Nick. I've saved that booklet to my computer for later use! It also answered my questions about insect repellants (the new Picaridin instead of Deet, apparently is too low a dose here in the US--I'll have to find the 20% before my next trip). Also talks about the confusing sunscreen/deet application.

Nick-H

Guess where I first heard about that publication!











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Hotstepper44

cheers loadsa useful information.
Jus one more quickie, i am presuming if a stay was to be for a few years the same rule applies - u have to take the medication for the whole duration? ie. 5years

What if u were to become a permanent resident over there?

Nick-H

Its your choice.

The publication I mentioned talks about medium and long-term as well as holiday visits.

You may well, if that is the case for you, decide not to take anything. The decision would have to take into account what area you would be living in and what kind of work you would be doing etc; I don't think there are any instant answers.

Diagnosis, whether you take the pills or not, is the next important thing. It's a quick blood test; you should not let any suspicious fever pass without investigation.