Best malaria tablets for Uganda?

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banzer
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Best malaria tablets for Uganda?

Post by banzer » Thu Oct 11, 2007 11:46 pm

Doxycyline, Malarone, or Mefloquine?

The doc has given me a few pros and cons but it's basically down to me. Any recommendations? I have no conflicting medical conditions, except a dodgy elbow after an hilarious line down Poldubh.

Ta. Rich
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Steve Davies
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Post by Steve Davies » Thu Oct 11, 2007 11:58 pm

Hi Rich,

Yours doc's not being vague! Its pretty much down to you, see this link:

http://www.traveldoctor.co.uk/africa.htm#3rdc

Have you ever taken anti malarials, I trevel regularly to China & India and have taken all of the three you mention. After two to three days I end up with a loud ringing in my ears, but i continue.

But the important thing is to take one of them. Malaria is not a pleasant illness.

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Post by DaveWortley » Fri Oct 12, 2007 1:52 am

Although it won't stop you catching malaria.

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John Kennedy
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Post by John Kennedy » Fri Oct 12, 2007 2:25 am

Everything I've heard is always to just buy the doxy over there.
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Post by ChrisBainbridge » Fri Oct 12, 2007 6:12 am

Doxycycline is cheap but does not work very well.
mefloquine (lariam) is a very nasty drug http://www.indiana.edu/~primate/lariam.html personally I would not touch it with a bargepole. From other reports that I have seen it was developed for the US army, never properly tested and then released without proper supervision. It would almost certainly never make it to market if it was developed today.

Malarone is pretty good. The only problem I found is that it causes insomnia. I finally realised what was causing my sleepless nights after 5 straight nights without sleep. I would suggest taking it in the morning not the evening.

Have a great time in Uganda

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Post by sarajames » Fri Oct 12, 2007 8:17 am

John K wrote:Everything I've heard is always to just buy the doxy over there.
It is considerably cheaper to buy Doxy over there. However as you are supposed to take it for a week or so before you go out there I would recommend getting a small supply for when you are in england and then buying the rest when you are out there.

You can also buy Malarone and Larium (Mefloquine) out in Uganda, however these are harder to get hold of. From my experiance you can only get them in Kampala rather than Jinja.

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Post by steddyjames » Fri Oct 12, 2007 9:14 am

I've found Malerone to be easy to take and I didn't have any side effects. Although this is the most expensive (nearly £30 a pack I think).

Also you only need to start taking it 24-48hrs before you get into a malarial area and for 5-7 days after leaving.

My brother-in-commonlaw got Malaria from a paddling trip to Uganda and it wasn't pretty.....he had to have 6 months off beer!!!! He didn't take Malerone but I can't remember if it was doxy or larium he took.

SJ

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Doxy

Post by nichburton » Fri Oct 12, 2007 9:49 am

Be warned that one of the possible side-effects of doxy is hyper-sensitivity to sunlight. Combine that with a day on the water at the equator and you've got a recipe for mega-sunburn unless you take very good precautions. I was using factor 50 waterproof suncream twice a day and my hands were still so burnt that I couldn't see my knuckles for the swelling. Not recommended.

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Post by clarky999 » Fri Oct 12, 2007 9:50 am

SteddyJames said:
got Malaria from a paddling trip to Uganda and it wasn't pretty.....he had to have 6 months off beer!!!!
Christ now there's an incentive not to get malaria!

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Post by mattyj » Fri Oct 12, 2007 10:00 am

Doxy has the benefit that it cures a lot of stuff on the side, the runs for one. But always gives me heartburn unless I take it with about a litre of water!
I also echo the comments of hyper-sensitivity to sunlight.

Malarone does cause side effects in me, weird dreams and insomnia. Although the dreams are occasionally quite entertaining.

I have no experience of the other one. I spend a lot of time, in quite long stays, in Africa working and given the choice I'd go for Malarone (the sunburn things a pain with me). Although the company I work for pays for my meds, and the last time I had to buy some myself I think boots charged me £1.50 a tablet of Malarone.

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Post by Pete the kayaker » Fri Oct 12, 2007 10:10 am

You'll get conflicting advice from the internet, so it may be wise to see the nurse at your local GP clinic.

However, from experience (and some looking into it), I would advise the following...

1. Choose Malarone - it is the the most effacious and has the least side effects. (yes, it is the most expensive 2 boxes will be approx £70), but WTF, you want to enjoy your holiday.

2. Do not buy cheap drugs abroad - quite frankly this advice is astonishlingly idiotic.

3. Make sure you take precautions - mossi net, repellents and covering up in the evenings - try to avoid being bitten.

Have a good trip.
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Post by Dave Manby » Fri Oct 12, 2007 10:15 am

Apart from taking the correct pills - which ever brand you finally select - preventing getting bitten is the best thing to do especially when you are drunk!

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Post by rvenab » Fri Oct 12, 2007 10:17 am

I became quite ill when I took larium, nasty stomach pains and dizziness. So I switched to Doxy and found that just fine. My dad has also been a couple of times since and he took Doxy and hasn't come back with malaria. It is also quite a bit cheaper than malorone.

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Post by Chaucer » Fri Oct 12, 2007 10:24 am

Both my wife and I took Lariam (Mefloquine) when we went to Tanzania on our honeymoon. We suffered no ill effects, and we didn't catch Malaria. So don't believe all the negative hype about Lariam.

If you read the side effects list of any modern drug, you would probably be put off taking it. They list all possible side effects in order to avoid being sued, not necessarily because they cause them.

Having said all this, we also took our own mosquito nets with us, and bottles of 50% and 100% Deet. It is not recommended that you put 100% Deet on skin, but you can put it on the outside of wristbands, trouser legs, boots etc.
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Post by Pete the kayaker » Fri Oct 12, 2007 10:34 am

Chaucer wrote:It is not recommended that you put 100% Deet on skin,
By who? - Some people may have an adverse reaction but others will be unaffected. Try a test spot first.
Chaucer wrote:but you can put it on the outside of wristbands, trouser legs, boots etc.
Do not try this on anything made of synthetic material or you'll discover the amazing melting properites of DEET ;)
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Post by Adrian Cooper » Fri Oct 12, 2007 11:05 am

Pete the kayaker wrote:I would advise the following...

2. Do not buy cheap drugs abroad - quite frankly this advice is astonishlingly idiotic.
Could you please clarify this Pete, it sounds contradictory.

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Post by little tim » Fri Oct 12, 2007 11:12 am

I've used Doxy both times I've been to Uganda with no problems. It can give you sensitivity to sunlight, but it'll be obvious if it happens so you can swap. I rarely wore suncream in Uganda and didn't burn.
If you do get doxy, don't forget to take it with food, otherwise you'll feel very ill.

I've heard anecdotal evidence that Doxy is less effective now, but the latest published research (July 2007) put it still at around 97% effective.

I wouldn't suggest waiting to buy doxy in Uganda - it's cheap enough here (£30 for 3 months), as long as you ring around a few chemists to avoid rip-off ones.

As suggested, take long sleeve shirts and trousers for evenings and nights and don't forget to deet up. ALWAYS sleep in a tent or mossie net.

I would suggest that unless you have a history of depression in the family, you'll be ok with Larium, but switch if you get trouble.

Mefloquine is obviously easier and (supposedly) has less side effects, but is hugely expensive.

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Post by Pete the kayaker » Fri Oct 12, 2007 11:21 am

Adrian Cooper wrote:
Pete the kayaker wrote:I would advise the following...

2. Do not buy cheap drugs abroad - quite frankly this advice is astonishlingly idiotic.
Could you please clarify this Pete, it sounds contradictory.
Of course... I was referring to this.
John K wrote:Everything I've heard is always to just buy the doxy over there.
Buying drugs abroad in places like Uganda, where the licensing for selling pharmaceuticals is somewhat less stringent than it is in the UK, opens you up for the possibility of obtaining counterfeit products.

These may be (at best) ineffective or (at worst) harmful.

Also, depending on where you are (i.e. Arabic nations especially); the legality of buying medicinal drugs is questionable - if caught, you could end up in a whole heap of sh*t!
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Post by neilfarmer » Fri Oct 12, 2007 12:01 pm

Doxy-cycline is also an antibiotic, so that may help with the dirty water. It does however make you burn much more easily. I took it when I went to India, it was fine, but very unpleasant on an empty stomache.

Malarone was fine, but expensive.

It was implied by my doctor that at the time (Easter 2005) it was not the recommended drug for Uganda, as some drugs are more effective with certain malaria strains than others... etc. Also, each drug becomes less effective with time as the mosquitos/malaria becomes resistant.

Covering up for the Malaria is essential (lots of people don't) and Iodine essential for all of your cuts/sores after exposure to the river. Some people don't do this and get ill! Choices people make!
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Post by steddyjames » Fri Oct 12, 2007 12:11 pm

neilfarmer wrote:
Covering up for the Malaria is essential (lots of people don't)
I think this is the key. Don't get bitten and you won't get malaria.

My limited understanding of malaria is that no drug stops you from getting the malaria parasite, it just hinders certain parts of it's life cycle once in the body with the aim of wiping it out. Specifically it's reproduction in red blood cells. This mode of action isn't full proof so even if you are taking the drug you can still be zapped.

Cover up, sleep in nets and plaster on the DEET. Don't bother with any other repellent, even though they may work short term (couple of hours) DEET's the Daddy.

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Post by ian pooleman » Fri Oct 12, 2007 12:40 pm

Hello,

I did my medial elective in Uganda this summer. Uganda, as with the whole of Africa does have a problem with low quality imported drugs. But there are plenty of reputable pharmacies selling adequate quality drugs all over Uganda. In Jinja, I used BLT pharmacy near one of the petrol stations in the middle of Jinja on several occasions and if you need medications whilst your there then they are as good as anywhere. But its your call if you buy stuff before you go or when you get there.

Of the people I met in Uganda over the 4 months I was there the majority were long term (well over a month) travellers who couldn't really afford malerone but people seemed to have little problem with doxycycline. Its what I took for my time there, it does work, make sure you take it when you get home for at least 2 ideally the full 4 weeks, as you still have the malarial parasite in your blood. Its worth noting that some people do have side effect with malerone too. Its not perfect!!

The surgeon I was visiting said her personal experience of people taking Larium is awful, they nearly always have 'larium' days when they feel a bit spaced or ill and at worst have full on psychotic episodes.

I can confirm that Doxy made me feel horrible, towards the end of my time I would vomit if I took it on an empty stomach but it was always fine with food.

Mossies arn't that bad at NRE, but its best to cover up and use deet. The 50% stuff is fine and can be put on your skin without destroying it.

Thats enough rambling, any questions get in touch.

Ian

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Post by Chrace » Fri Oct 12, 2007 1:24 pm

I trotted up Kilimanjaro in February using the weekly tablets (Malarone?). They are easier as it's once a week (thus I could do the whole climb inbetween pills) but the first 1-2 weeks you dream like h... the night after taking them. Not nightmares, just dreaming - great ride.

You also don't have to bring as many of them and can leave them at the hotel even if you're on 3-4 days trips.

I'd go with them again even if they're more expensive.

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Post by Chrace » Fri Oct 12, 2007 1:33 pm

steddyjames wrote:I think this is the key. Don't get bitten and you won't get malaria.
Yeah right. Tell that to the mosquitos. I got the same advice for sleep disease from Tsetse flies. Baah, humbug!

You'll be sleeping next to a river(!) and though you need to cover up/sleep with net/use whatever you can find to splatter all over your body you'll still be sitting outside at night having a beer.

Expect to be bitten, because you will. If lucky (80%?) it won't be by one carrying the disease. If it carries the disease, at least reduce the risk of catching it by 50%.

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Post by John Kennedy » Fri Oct 12, 2007 2:15 pm

Pete the kayaker wrote: Buying drugs abroad in places like Uganda, where the licensing for selling pharmaceuticals is somewhat less stringent than it is in the UK, opens you up for the possibility of obtaining counterfeit products.

These may be (at best) ineffective or (at worst) harmful.

Also, depending on where you are (I.e. Arabic nations especially); the legality of buying medicinal drugs is questionable - if caught, you could end up in a whole heap of sh*t!
True, but then the guy telling me this was also going on about how freely available vikadin and valium were too...
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Post by Pete the kayaker » Fri Oct 12, 2007 2:27 pm

John K wrote:True, but then the guy telling me this was also going on about how freely available vikadin and valium were too...
Oh that's alright then... go for it! :)
ian pooleman wrote:Uganda, as with the whole of Africa does have a problem with low quality imported drugs. But there are plenty of reputable pharmacies selling adequate quality drugs all over Uganda. In Jinja, I used BLT pharmacy near one of the petrol stations in the middle of Jinja on several occasions and if you need medications whilst your there then they are as good as anywhere. But its your call if you buy stuff before you go or when you get there.
You may well be right that this was a perfectly reputable pharmacy, but how do you distinguish the slightly less reputable ones? Is this particular pharmacy still in the same ownership?
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Post by Adrian Cooper » Fri Oct 12, 2007 3:26 pm

Pete the kayaker wrote:
Adrian Cooper wrote:
Pete the kayaker wrote:I would advise the following...

2. Do not buy cheap drugs abroad - quite frankly this advice is astonishlingly idiotic.
Could you please clarify this Pete, it sounds contradictory.
Of course... I was referring to this.
John K wrote:Everything I've heard is always to just buy the doxy over there.
Buying drugs abroad in places like Uganda, where the licensing for selling pharmaceuticals is somewhat less stringent than it is in the UK, opens you up for the possibility of obtaining counterfeit products.
I see, when you said 'idiotic' it was like saying ''bl**ding obvious'', not ''bad advice''.

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Post by ian pooleman » Fri Oct 12, 2007 4:03 pm

Valium is very available. You can just buy it over the counter.

Generally most of the drugs in the pharmacies are have a pretty reputable source. Its the tablets that are being sold by 'healers' and the pharmacies that you see in little shacks at the side of the road. If your particularly worried about the quality of medication then International Air Ambulance has a clinic in Jinja, and the international hospital in Kampala is probably the most reputable in the country if not the region.

ian

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Post by Liam » Fri Oct 12, 2007 7:35 pm

Coming in late to this thread,

Apart from malarial drugs, are there any other jabs/drugs that are advisable for folk travelling to Uganda?

I'm off next spring/summer and everyone here in Spain says its fine, not even worried about malaria!

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Post by MattC » Sat Oct 13, 2007 2:27 am

Being on a bit of a budget, I took Larium whilst there last summer. No side effects at all. Some people I spoke to however did get crazy dreams and such like but I think that's why you're meant to take them three weeks before you head out, just in case you don't agree with them so you can then swap.

Matt

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Post by tfraser » Sat Oct 13, 2007 6:17 am

Is it true there is no longer 100% treatment due to recent new resistence?Holiday companies dont seem to realise this.Could a doctor coment?

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