Malaria Medication - Yes or no???

akh · Mar 22nd, 2007, 10:22

Hi,
We are moving to Chennai from Australia for 3 years and were wondering what everyone's advice on whether or not we (myself, husband and two young kids) should take the malaria medication or just use preventative measures like repellent and nets etc

Some people have said take the mediction and others say no one bothers in Chennai?
I have researched the medication we would need to take and i am a bit worried about the side effects it can cause.
Any advice???

SteamBuff · Mar 22nd, 2007, 15:42

I would advise you to go and speak to your doctor or travel clinic to see what their advice is on Maleria medication. (and other vaccininations as well) Also speak to a Doctor in Chennai when you arrive to get his/her advice as well.

Since you are moving to India, you really need to understand the long term effects, this is best done from a professional and not from the Internet. (I have seen wildly conficting information on the net)

There is Maleria all over India (except areas over approx 2000m) at certain times of the year.

This is important as young children are involved.

Nick-H · Mar 22nd, 2007, 16:14

It is not seasonal... Malaria is present all year.

I suspect that Steambuff meant that maybe the mosquito risk is slightly less during some times.

It seems that the official advice is moving from prophylaxis to avoidance/treatment.

Many threads here to contemplate...

icetea · Mar 22nd, 2007, 19:05

Quote:

Originally Posted by akh

Some people have said take the mediction and others say no one bothers in Chennai?I have researched the medication we would need to take and i am a bit worried about the side effects it can cause.
Any advice???

Now that is a bit strange, because Chennai is in no way sheltered from mosquito&malaria menace, on the contrary.

Akh, the decision is up to you, there is no yes or no. Most people take medicines, some people don't. But then, most of them are in India for a shorter time, so side-effects are not so dangerous. But even among long-timers here on IM, my impression is that most of them do take anti-malaria stuff. That being said, I for example don't take any.

It's not at all a bad idea seeing a doctor, since small children are involved. I would not give them such medication without medical advice, especially not for a long period.

edwardseco · Mar 22nd, 2007, 20:31

Long term and children complicates matters a lot depending on the age of the children. No prophylaxis is indicated for long term use (sorry Nick). Only Malarone (prohibitively expensive) has not been contraindicated for long term use. Use a net and go with the risk necessary..

Nick-H · Mar 22nd, 2007, 21:10

I don't take anything any longer.

The last time I had worrying symptoms I took the test, got the negative result in a few hours and just went back to bed to sleep off the flu.

If anything, I've been more worried about Chikungunya and Dengue this past year. Yes... sleep under a net.

But avoiding mosquito bites completely is just impossible

cool blue · Mar 23rd, 2007, 17:42

I arrived in Chennai in January so I can vouch for the mossies and their appetites!

I agree that the most sensible thing to do is to clarify this before you come. I had to have medicals etc prior to my appointment here and part of that process included a Health Briefing which looks at immunisations etc. at that time it is good to get a clear medical opinion on malaria. (the advice i received was bite avoidance - which i agree is not easy at all!) but this is only one opinion.....so, best to get the right advice for you and your famiy

all the best for your move here

Good luck

Nick-H · Mar 23rd, 2007, 22:36

Quote:

Originally Posted by cool blue

I arrived in Chennai in January ...

Good Grief, everyone is on their way here!

Danie · Mar 25th, 2007, 00:36

Better safe than sorry, I say. If you plan to travel at all you may likely be in areas that are higher risk than Chennai.

We're taking the meds with us.

Kind regards,

Danie

kidsan · Mar 25th, 2007, 01:04

Quote:

Originally Posted by Nick-H

If anything, I've been more worried about Chikungunya and Dengue this past year. Yes... sleep under a net.

what is the score with dengue? when i was in india last autumn there was a bit of a panic going on but since then i have heard very little about it. Is delhi still under dengue siege as they had us believe back then?

gregornot · Mar 25th, 2007, 07:42

Namaste,
I was taking malaria meds and the were making me sick went to a Doctor and he said that there was not use in taking them. I was going to Ardh Kumbh Mela: Allahabad, India January, 2007 and was in Varanasi in Jan 2007, So I stopped taking them so did my 17 year old son and we were lucky as we made it back with out getting Malaria.

But I know a lot of old IM timers swear that you need to take them no matter what. If they did not make me sick I would have continued
taking, my son lost(?) his meds, but of course he feels that he is going to live forever.

But I say take them.

Peace, gregor

Nick-H · Mar 25th, 2007, 10:05

Quote:

Originally Posted by kidsan

what is the score with dengue? when i was in india last autumn there was a bit of a panic going on but since then i have heard very little about it. Is delhi still under dengue siege as they had us believe back then?

Like the rest of the world, things here appear in the newspapers for a few days and then become old news... I don't know what the current situation is.

ISTR reading that the mossies that carry the Dengue and Chickungunya really don't like the cold, and that Delhi's winter was expected to substantially reduce the problem.

I haven't heard about Chickungunya here since last summer. Very many people did catch this nasty and painful disease, but the waters are always muddied by those who just have a bad bout of the flu and label it as whatever today's popular disease name happens to be.

edwardseco · Mar 25th, 2007, 13:09

I wouldn't recommend taking it if it makes you ill especially since you have a choice of several types. Course its also true that people don't read the info sheet to find out how its supposed to be taken (at least with Doxy). Well, at least I am reassured that Nick's liver will be up to some Old Monk someday..

Nick-H · Mar 25th, 2007, 13:49

Naahhh.... I do my liver in with occasional doses of Kava Kava.

Actually, come to think of it, probably better for it than Old Monk!

Sometimes I wonder, though --- when I see people saying that they don't want to take medication 'long term' when they are only coming for a few weeks. I think 'long-term' in terms of the dangers of most of these meds is years not weeks! I guess it varies for each one, one would have to check the data available...

cyberhippie · Mar 25th, 2007, 16:13

From the HPA website

Some guidelines on long term usage of anti malarials

Quote:

Chloroquine
Chloroquine has been taken safely for periods of many years at doses used for malaria chemoprophylaxis. However, there has been concern expressed about the possible development of retinal toxicity with long term use of chloroquine (or hydroxychloroquine, often used to treat rheumatologic disorders). Retinal toxicity has been described in those on daily chloroquine dosage for rheumatic disorders. As a result, two thresholds for the risk of retinopathy have been suggested:

* A total cumulative dose of 100g of chloroquine base
* A daily dose of 250mg base (4mg / kg) (Luzzi, 1993)

The first threshold would require an adult to take chloroquine continuously, weekly, for a period of six years. The second threshold is far in excess of the prophylactic dosage. It has been concluded that the risk of retinopathy from prophylactic dosage alone is negligible (Hill 1995). Further reassurance can be gained from the fact that retinopathy has only rarely been reported in patients taking weekly prophylactic dosages (Luzzi, 1993; Lange, 1994)

ACMP advice suggests that chloroquine can be taken on a long-term basis. However, physicians should consider an ophthalmologic examination every 6 -12 months, beginning at six years' cumulative use for those on long-term chloroquine.

Proguanil
There is no time limit specified for the use of proguanil. Therefore, it can be taken continuously for several years.

Mefloquine
There are few data on the use of mefloquine for periods exceeding two years, although there is no evidence of cumulative toxicity, and mefloquine taken for over 1 year is well tolerated. The product licence suggests mefloquine can be taken continuously for a period of up to 12 months. However, advice from the ACMP indicates that there is no evidence of harm in long term use if the drug is tolerated in the short term, and suggests that mefloquine can be used safely for up to three years in the absence of side effects.

Doxycycline
Doxycycline is licensed for up to two years or more in the treatment of acne in the same dose as is used for malaria prophylaxis. The ACMP have concluded that there is no evidence of harm in long-term use of doxycycline and it may be taken safely for periods of at least up to two years.

Atovaquone / proguanil (Malarone™)
Both components of Malarone have been used individually on a long term basis, although there is little experience of long-term use of the combination. Many countries do not restrict the length of time Malarone can be taken although the UK product license states it can only be taken for travel up to 28 days.

There is a report of Malarone use for periods from 9 to 34 weeks, in which there was no excess of adverse effects and no appearance of unexpected adverse effects (Overbosch 2003). The ACMP concludes that there is no evidence of harm in long-term use and suggests that it can be taken confidently for travel up to one year or longer. Nevertheless, long-term use of Malarone should be prescribed with careful consideration until additional post licensing experience is available.

Mar 22nd, 2007, 10:22	#1
akh Member Join Date: Mar 2007 Location: Sydney, Australia Posts: 4	Malaria Medication - Yes or no??? Hi, We are moving to Chennai from Australia for 3 years and were wondering what everyone's advice on whether or not we (myself, husband and two young kids) should take the malaria medication or just use preventative measures like repellent and nets etc Some people have said take the mediction and others say no one bothers in Chennai? I have researched the medication we would need to take and i am a bit worried about the side effects it can cause. Any advice???

Mar 22nd, 2007, 15:42	#2
SteamBuff Senior Member Join Date: Nov 2006 Location: Essex, Endland Posts: 370	I would advise you to go and speak to your doctor or travel clinic to see what their advice is on Maleria medication. (and other vaccininations as well) Also speak to a Doctor in Chennai when you arrive to get his/her advice as well. Since you are moving to India, you really need to understand the long term effects, this is best done from a professional and not from the Internet. (I have seen wildly conficting information on the net) There is Maleria all over India (except areas over approx 2000m) at certain times of the year. This is important as young children are involved. Last edited by SteamBuff : Mar 22nd, 2007 at 15:55. Reason: Spelling

Mar 22nd, 2007, 16:14	#3
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 25,811	It is not seasonal... Malaria is present all year. I suspect that Steambuff meant that maybe the mosquito risk is slightly less during some times. It seems that the official advice is moving from prophylaxis to avoidance/treatment. Many threads here to contemplate... __________________ . Just one member of the IndiaMike Mod Team

Mar 25th, 2007, 07:42	#11
gregornot Senior Member Join Date: Jun 2006 Location: UT,SLC-CA,-Bay Area Posts: 248	Malaria Meds yes or No ? Namaste, I was taking malaria meds and the were making me sick went to a Doctor and he said that there was not use in taking them. I was going to Ardh Kumbh Mela: Allahabad, India January, 2007 and was in Varanasi in Jan 2007, So I stopped taking them so did my 17 year old son and we were lucky as we made it back with out getting Malaria. But I know a lot of old IM timers swear that you need to take them no matter what. If they did not make me sick I would have continued taking, my son lost(?) his meds, but of course he feels that he is going to live forever. But I say take them. Peace, gregor __________________ To conclude with the ever inspiring words of the Buddha: "If the roots remain untouched and firm in the ground, a felled tree still puts forth new shoots. If the underlying habit of craving and aversion is not uprooted, suffering arises anew over and over again." ~Dhammapada XXIV verse 338

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Mar 22nd, 2007, 20:31	#5
edwardseco Maha Guru Member Join Date: Sep 2001 Location: Land that shakes and bakes. Posts: 3,777	Long term and children complicates matters a lot depending on the age of the children. No prophylaxis is indicated for long term use (sorry Nick). Only Malarone (prohibitively expensive) has not been contraindicated for long term use. Use a net and go with the risk necessary..

Mar 22nd, 2007, 21:10	#6
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 25,811	I don't take anything any longer. The last time I had worrying symptoms I took the test, got the negative result in a few hours and just went back to bed to sleep off the flu. If anything, I've been more worried about Chikungunya and Dengue this past year. Yes... sleep under a net. But avoiding mosquito bites completely is just impossible

Mar 23rd, 2007, 17:42	#7
cool blue Senior Member Join Date: Jan 2007 Location: India Posts: 133	I arrived in Chennai in January so I can vouch for the mossies and their appetites! I agree that the most sensible thing to do is to clarify this before you come. I had to have medicals etc prior to my appointment here and part of that process included a Health Briefing which looks at immunisations etc. at that time it is good to get a clear medical opinion on malaria. (the advice i received was bite avoidance - which i agree is not easy at all!) but this is only one opinion.....so, best to get the right advice for you and your famiy all the best for your move here Good luck

Mar 25th, 2007, 00:36	#9
Danie Danie in Chennai Join Date: Dec 2006 Location: Chennai Posts: 50	Better safe than sorry, I say. If you plan to travel at all you may likely be in areas that are higher risk than Chennai. We're taking the meds with us. Kind regards, Danie

Mar 25th, 2007, 13:09	#13
edwardseco Maha Guru Member Join Date: Sep 2001 Location: Land that shakes and bakes. Posts: 3,777	I wouldn't recommend taking it if it makes you ill especially since you have a choice of several types. Course its also true that people don't read the info sheet to find out how its supposed to be taken (at least with Doxy). Well, at least I am reassured that Nick's liver will be up to some Old Monk someday..

Mar 25th, 2007, 13:49	#14
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 25,811	Naahhh.... I do my liver in with occasional doses of Kava Kava. Actually, come to think of it, probably better for it than Old Monk! Sometimes I wonder, though --- when I see people saying that they don't want to take medication 'long term' when they are only coming for a few weeks. I think 'long-term' in terms of the dangers of most of these meds is years not weeks! I guess it varies for each one, one would have to check the data available...

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