My husband and I are planning our first trip to Africa. I have just picked up two books to help with the planning. Last night I read a whole chapter about the health issues [more specifically, Malaria] and got a little freaked out to say the least! The book went into great detail all about the dangers and the extreme precautions that you must partake in to protect yourself. It almost did not seem worth the trip. Please... someone set my mind at ease about this topic. On a side note, we are planning on starting a family within a year of returning and I can't bear the thought of this trip to Africa affecting our family plans because one of us contracted a horrible disease.

There is absolutely no reason for someone to contract malaria these days, as there are very effective preventative medications, with the most prominent one being Malarone. You need to start taking it a couple of days before you leave your home country, and then continue it after you return home, for something like 30 days, I think. Other precautions include wearing long pants and long sleeves around sunset, etc. Malaria is borne by mosquitos, so you need to have mosquito repellent available. We did take our own, but all of the camps that we stayed in--Wilderness camps in Botswana--all provided mosquito coils and lotion. All of that said, we travelled in May, 2005 and we saw virtually NO mosquitoes. It depends to a great extent, WHERE you travel and WHEN. Africa is a very big continent and what can be a small problem in some places is a huge problem other places, and not a problem at all in yet another place.

We went to our doctor 3 months before our trip, and he asked us for the specific COUNTRY within Africa that we would be visiting, and there was a source book that he consulted, from the CDC possibly?? Not sure, but anyway, he got specific recommendations for which shots and other medications that we should have. As I said, we stayed in Wilderness camps in Botswana, which was very high end, granted, but all the food, water, etc., was extremely safe there. If you are considering someplace less high end, you probably should be more concerned with regard to the safety of water and food, so that you don't get a case of Montezuma's revenge. Again, our doctor also gave us some medication up FRONT to battle diahherea, and an antibiotic, in CASE we needed those things. Thankfully we did not need to use them, but I was very glad we had them.

Malaria is a risk in many tropical countries and, though prophylaxis is available, it is never 100%. Some of the drugs used for prophylaxis may also have side effects varying from digestive upsets to serious neurological problems - the incidence of side effects is low but they can mess up your holiday and have long lasting effects. You are taking a risk and only you can decide whether the rewards justify the risks.

From my personal experience, one of the drugs used is Lariam (Mefloquine) and my sister suffered serious side effects from it that stopped her being able to work for about 5 years. Many people (including me) have taken Lariam and suffered no side effects. Search the web if you want more information.

I'm sure your physician will be able to offer you up-to-date advice on the areas with higher or lower risks and/or the appropriate drug regimes.

<img src="http://www.traveltalkonline.com/forums/images/graemlins/Cheers.gif" alt="" />

Malerone is good but is rather expensive. Larium (Which is what I use BTW) causes mental problems in about 10% of users. Myself all I ever have is really vivid dreams. Deoxy makes you sunsensitive and if you are a woman on Birth control it can render it ineffective and can make you prone to a Candida infection if taken long term.

A good battery of shots Hep A+B is wise. Time release DEET repellent (Sawyers) and treatment of outerwear with Premethrin is a very wise course.
More hints:
Limit time spent outdoors at dawn and dusk, when many mosquitoes are most active
· Wear light-colored protective clothing such as long-sleeved shirts, long pants, and a hat when outdoors in areas where mosquitoes are present
· A long sleeve shirt with snug collar and cuffs is best. The shirt should be tucked in at the waist. Socks should be tucked over pants, hiking shoes, or boots
· Light colored clothing is best because mosquitoes tend to be more attracted to dark colors
· When going outdoors use insect repellents that contain DEET or other approved ingredients
· Make sure that door and window screens fit tightly and have no holes that may allow mosquitoes indoors
· To avoid insect bites, do not use scented soaps, perfumes or hair sprays.

Good sites:
http://www.priory.com/malaria.htm
http://www.traveldoctor.co.uk/tables.htm

Taking a good antibiotic like Ciproflaxin is in my mind a must.

If you are worried about travelers diarreha read more on it at my article here:
http://www.polosbastards.com/artman/publish/article_139.shtml

Best,
Stiv

Thanks for that additional info. Malarone is rather expensive, yes, and stupidly enough, our insurance (Blue Cross) wouldn't pay for it. They WOULD pay if we had gotten malaria, though. Whatever... We paid for it out of pocket. Can't really remember, but think the cost per person was around $100???? Don't really remember now.

Just as an update FYI with regards to malarial meds. I'll be spending next month in Thailand and some malarial zones kicking back and doing some tsunami follow up and Bangkok demo stuff and some slacking so I'm taking malarone this time as much of SE Asia is becoming Larium resistant.

The price of it has come down a bit from a few years ago and my insurence actually did cover up to 30 tabs. I needed 48 (Got to cover the partner too) so I had to pay out of pocket for the difference and with the copay came out to a little over $100US for 48.

So yes in the relative scheme of things Malarone is still expensive but with some parts of the globe aquiring resistance to Larium and the psycho side effects some folks have with Larium, Malarone is definately something to really consider.