Malaria Tablets SA and SEA

Snowbride 2011

Hey,

Currently preparing for an 8 month RTW trip. Husband and I are heading off beginning of July and we've had most of our shots at this stage. The doctor also gave us a prescription of 220 Malarone tablets each which is to cover 4 months in SA (Peru, Bolivia, Paraguay, Argentina and Chile) and 3 months (Thailand, Vietnam, Cambodia & Laos).

From what I've read, this looks like it will cost anywhere between 1000-1400 euro and we just hadn't factored in this cost.

I'm a little confused on what our options are to reduce this: there is mention of the drug payment scheme, could this mean that the cost may be capped at €500 total (€125*4 months) per family for the south america leg? We fly into Peru - can any other travellers advise? Should we wait and get tablets for the second leg of our trip in SEA?

All comments are very much appreciated...

hoopla87

hi there, heading to SEA at the end of july myself and we were informed that unless we're intending to really go way off the beaten track into dense forestry and the like we would be better off without malaria tabs because we'd avoid the side effects. Just make sure to be vigiliant with using DEET and wear long trousers/sleeves at night and bring a mossie net. south america i cant comment on sorry but maybe this would reduce ur bill a bit anyway??

Sandwell

Myself and my wife are in a similar position - leaving in July and going to be spending around half of the next year or so in malarial areas. I know the TMB and probably most doctors recommend Malarone due to the limited side effects but I think it's more suitable or short-term travel, that is unless you're prepared to pay huge money for anti-malarials. The other options - doxyciline and mefloquine - are much cheaper and have served the majority of users well over the years. Sure they have side-effects but they're manageable for most. Have you considered using them at all?

stringed theory

I usually take mefloquine because it's only once a week, though there are some resistant malaria strains on the Thai Burmese border and elsewhere. Mental disturbance is listed as a side effect, though I haven't noticed! Many travellers to the main SE Asia tourist destinations take nothing, or buy doxycycline over the counter when they get there. Mefloquine is harder to find.
Argentina and Chile are malaria free, except for the far north. As for the other countries, it depends on altitude. If you're flying into Lima and on to Cuzco, and continuing overland to Bolivia, and staying mostly in the highlands, you might not have to take anything.
Unless your doctor has an interest in tropical medicine and has gone into all of this I'd do some research.

Six of One

I don't know about SEA but I travelled Chile, Argentina, Bolivia and Peru and didn't take any malaria tablets. This was following a good bit of online research, speaking to friends that had travelled and getting a friend who's dad is a tropical medicine speacialist to ask his dad for me. The consensus was that unless you are trekking through the Amazon you don't really need them. Having said that I was there in June, July and August so you would need to check seasonal differences.

Snowbride 2011

Thanks for all the responses. I've been doing research online and its one half dozen or the other on whether to take the tablets the entire time you are there...plus there are the side effects to consider.

I've been on the WHO site and it certainly seems some areas are less affected that others. I think I'll use this as a guide and bring some supply incase we head off the the Amazon or go to higher risk countries

Spot on stringed theory - we are actually heading to Lima -> Cuzco -> Bolivia for the first month or so. It seems that with a bit of DEET we should be fine in the highlands.

Sandwell; I hadn't heard of mefloquine so will check it out now. Thanks