anti-malarial advice please

[travellingson]

DS going to Africa for a month in the summer. Need to decide which anti-malarials to get private prescription for. Doxycycline or Malarone have been recommended. Doxyclcline is about 1/10 of the price but has to be taken for a month on return (still makes it much cheaper but a long time for a teenager to remember to take it); Malarone only for a week on return.
I think the nurse said something about Doxy. also containing an anti-biotic, which might be useful for other purposes.
Anyone who really knows their stuff in this area - what are your thoughts? I can't decide... health & safety first, cost last consideration.. any help much appreciated. Thanks.

Doxycycline takes more compliance to complete the 4 weeks after he returns home. Is your DS a teenager? My own experience in travel health would advise you go for the malarone. Generally well, tolearted, better compliance as only needs a week more on return home. Doxycycline can also cause sun sensitivity, which may be an issue if your DS isn't v reliable with the sunscreen. HTH

thanks MrsJMartin. Yes, DS is a teenager, not sure either of us would remember for 4 weeks. Just recalled something about Doxycycline also being an antibiotic?

Prevention is the key IME. We lived in Thailand, home to malaria and dengue fever. A good DEET containing repellant is better than all the anti malarial drugs in the world. He should cover up, ankles are particularly attractive to mosquitoes.

If he wears contact lenses, he should take particular care with the repellent. I think DEET melts plastic.

Prevention is key:
cover up between sunrise and sunset
insect repellent
avoid bright coloured clothes
use a mosi net, must be tucked under mattress
take anti malarials
The antibiotic contained in the doxocycline will not be of any use to fight stomach bugs if that's what you are thinking OP!
Use whichever medication you think DC is more likely to take properly.

Definitely go for malarone. Only taking for a week after is a big plus and it's easy to take.
Prevention is key but can be difficult depending on where he's staying. Trousers and long shirt in evening and mosquito net at night. I did find it hard to get a mosquito net up sometimes. There iso e you can get which is a bit like a tent over the head (so didnt depend on hooks on ceiling etc) which seemed a good idea.

A few laundry pegs could be good to help with mosi net. Avoid pins as they can tear it.

Agree with Kreecher wholeheartedly And tuck trousers into socks. You can now get anti mos "sticker badges" for clothes, and anti mos wipes, both of which are really handy.

We have just been driving through Africa for 6 m with 2 chn 11&12. All the above advice is very useful but I would use malarone with caution and larium as well. Certainly doxy causes hyper sensitivity to the sun but he can cover up and use block out I was the only one of the 4 of us that reacted to the sun.
I certainly think the antibiotic factor helped us. We were camping/outdoors all the time and cuts and scratches were generally ok so that was a plus.
Deet products are very hard to get in a lot of places so he should go prepared. As much as I didn't like the idea of deet on us and our clothes everything else was ineffective.
Malarone affected 2 of my friends. One was out of his tree,hyper etc and the other became very twitchy,suspicious and odd. I know this is hardly a broad example but as far as I know doxy doesn't have psychological side effects which is also a big plus.
Remembering does become automatic. Best to take it when cleaning teeth first thing ( hopefully that is automatic!) at least he has the rest of the day to remember. Best not to take it at night as can cause GI upset. The most tricky time trying to remember is always when coming home.
Hope he has a fantastic time.

Lariam made me bonkers and insomniac. Very effective I am told but not well tolerated by everybody. I was normal on Malarone.

Malarone suited all of us - we took last thing at night so that we slept through any side effects. It is expensive though.

Just tell your DS to remember that he could still get malaria - it happened to several people on the trip DD was on, so you still need to look out for any signs.

I had a terrible time with malarone on my honeymoon. It is meant to be the drug that affects people least but I felt sick, lost my appetite, it was awfull.
I actually stopped taking it as it a low risk time of year and we were in a very low density population area (so less likely to get it) I was very cautious about DEET etc
Slightly bonkers I know but a very low probability of getting malaria versus cmoplete certainty it would ruin my honeymoon.

I had the most awful flu that winter though and convinved myself it was the malaria (it can lie dormant) It wasn't!

wouldn't touch larium with a bargepole. hideously awful stuff.

malerone is generally considered the most effective, and "nicest"

doxy ok, but sun sensitivity can be an issue, and (personal view0 I don't like the taking-abs-for-a-long-time bit of it (other medications are available in this instance, after all)

I found taking the malerone with eg a banana (nice, dense food) helped a lot (I have trouble taking all kinds of tablets/medications - not the swallowing, but the impact once they start dissolving in the stomach). take a broad spectrum high dose vit B too - this helps a lot.

wow, loads of responses - thanks everyone - tho I'm not sure I'm any closer to deciding as a result!!! They have been told to take mosi nets and DEET repellant as well as the tablets. Any advice re repellants? Those I've seen in the high street shops are max 50% DEET - is that ok or is there a higher one (being lazy, could google I guess!)
@ taking when cleaning teeth!!! There's a big group of them so hopefully they will all remind each other.

For the DEET, I always took the strongest one but it is very unpleasant and I am not sure that it is more effective than the other. In any case, the homebrand is fine.
I'd buy a spray (for arms and larger areas of the body or even clothes) and a roll on for the face. Spar for the face is horrendous, stings eyes unless you put on your hands first and then apply it.
Is it world challenge? Tanzania?

yes, World Challenge Elsie, to Namibia.

Well in that case you can chill big time. Went travelling there myself in the summer a few years back and there was zero mosquitoes at this time of the year. I seem to remember there is only a risk in the raining season (our winter) in a few areas. Namibia sucks for mosis, it's as dry as you can get!

oh do be careful with face rollon, make sure it's specifically face, I burnt my skin once with an anti mos roll on on the face

www.fitfortravel.scot.nhs.uk/destinations/africa/namibia/namibia-malaria-map.aspx
useful map

oh snap, Elsie - I was just oging to link to the fitfortravel map

have alwyas found them quite useful.

Doesn't say anything about the time of the year though.

when I lived in Africa, the time of year was not as relevant as the area - you were either in a malarial area, or not.

when I did some work with the army out there, their standard advice was to take antimalarials: even in malaria-free areas, due to travel to/from etc. there were areas where I would rely on eg hefty vit B doses, as the risk really was non-existant, but the army advice was always to take them.

yes indeed, DS might go in and out of the zone in which case he should hit the pills. And not be told about it in case he becomes complacent!

thanks - they have told they definitely need malaria tablets, spray, nets, cos of where in Namibia they are going (it varies, apparently). So we will do the works as advised by WC.. still not decided re which tablets.....

I thought they provided mosi nets? They used to.