Malaria control in Africa - Stan takes action

by Stan Rogers on 06 January 2012

The Roger couple is still preparing for their Africa trip where they'll take Tin Can, their trusted Land Rover Defender, through Garden Route, then to the Transkei, Lesotho and on to Johannesburg to visit a sister briefly. Then they will head westwards to Namibia, the Kalahari and on to Botswana where the Okavango comes with great recommendations. But every adventure has some hick-ups, if you will excuse the pun. As the medical preparations get underway, Stan realizes that the medical and maralial matters are way more complex than he (and a lot of other travelers) thought...

Never mind the fact that most other people in OZ upon hearing of our trip through Africa ask questions about the risks of:

· Wild animals

· Snakes

· Guys with Kalashnikovs

· Car breakdowns, etc.

what worries me most is the little microbes and insects. How to stay healthy will be a challenge. There are no easy answers and talk to your doctor, but what we have decided on is:

Vaccinations

Other than proof of vaccination against Yellow Fever, which is mandatory in a few Central African countries (the WHO yellow card) the rest are only “recommended”. But I would say you’re nuts if you don’t follow Mum’s recommendations. Also you can hardly front your friendly doctor the day before you intend to travel -as some vaccinations have to be spread out over a few weeks.

Photo by: clidstrom

Unfortunately many of our previous vaccinations for Asia and Morocco had expired and we had to submit to pain again. Our arms feel like pincushions and my wallet is USD$1200 lighter after having what I feel is essential:

· Hepatitis A & B (2 shots over 3 weeks)

· Rabies (3 shots over 4 weeks)

· Yellow Fever (1 shot)

· Diphtheria and Tetanus (ADT 1 shot)

· Typhoid (you can take tablets now)!

· Meningococcal C (1 shot – but I was surprised to discover that the vaccine against the strain that lives in Australia is no good if you want to tackle the bug in Egypt. You need something called ACWY vaccine for the Egyptian nasties).

· Cholera (Dukoral – but you drink it). Mostly because it helps against gastro bugs as much as Cholera itself – which you are not likely to catch.

Malaria control in Africa

This is the big one! We all know malaria in Africa is endemic across most of Africa and there is no vaccine (yet). A short trip (say a month) is easy enough – just take Doxycycline as a preventative. But if you are going to be in malarial areas for 6 – 9 months as we will be, despite a few possible preventatives, your problems with malaria control in Africa are:

1. Doxycycline can only be taken for up to 4 months as a preventative before it starts messing up your kidneys. (It also makes you sunlight sensitive).

2. Lariam (Mefloquine) does the same after 3 months – besides it can make you paranoid, hallucinatory and anxious. Although we’re not already!

3. Malarone is a newer drug, can be taken for up to a year and sounds great. (The US Army uses it). But it costs USD$5 per tablet per person per day – so work that out!

So, not wanting to chance taking nothing at all and on advice, we have decided on alternating one month Doxycycline then one month Lariam for the 9 months. Should give the old kidneys a bit of a break at least alternating hopefully?

Plus we will take all the other usual precautions:

· Long sleeves and pants (Permethrin treated) after dusk.

· Plenty of DEET insect repellent.

· Mosquito nets in the tent at night.

and have a malaria testing kit handy and hope for the best…

Photo by: Elizabetheastcobber

Water borne diseases

Water is nasty stuff some of the time! One should decidedly drink beer only! It can carry Bilharzia, Schistosomiasis and E Coli bugs to name a few.

We carry a 1-micron water filter with Silver hydride crystals which is supposed to clean and kill most of the nasties and all our water put into the vehicle tanks will pass through it. But I reckon on boiling even the filtered water before we drink it. And white water rafting in the Nile will be kept to a minimum to avoid Bilharzia!

One rule is never, never, never use chlorine or chlorine based products. The reason is, we as travelers take on water that has a lot more substances in it than the water does at home. If there is colour in the water that is from leaves, tree branches, etc; when this chlorine is added to the coloured/stained water it creates a by-product, which can cause cancer!

Other nasties

Besides a pretty large 1^st aid kit and Stan having a Level 11 1^st aid certificate, we will carry some antibiotics to treat:

· Stomach bugs (Ciprofloxacin)

· Infected wounds (Cephalexin)

· Ear/eye infections (Sofradex)

· Allergic reactions (Cortisone and antihistamines. Prednisalone)

Some thought has been given to buying a snake bite outfit with polyvalent anti venene in South Africa, but you really need more than just 2 ampoules of the stuff, it has to be kept in the fridge and is real dangerous to use without adrenaline on hand also to treat anaphylactic shock which can occur.