Anti malarial advice

[BramfieldWren]

Please can anyone let me know if they have given their baby (mine is 17 months old) malarone as an anti malarial?

My husband grew up in Kenya, his Dad is still there and we go every year. Last Christmas I didn't give my DD any anti malarial drugs, but i did take extreme precautions in keeping her under mosquito nets from just before dusk, well covered and coated in citronella! This year, I'm more worried because she is on the move. My friend's daughter reacted very badly to malarone but is it worse to give them nothing at all?

Nurses/doctors of course say take medication. People who have to deal with the consequences say don't.

Any advice gratefully received

With prophylaxis, there is a small but recognized chance of side effects.

With malaria there is a significant chance of death if you catch it.

It's your call.

I forgot to mention the fact that locals say the mosquitos are becoming immune to the drugs and they can do more harm than good. People are never immune through taking the drugs and if you get malaria anyway, it can be harder to fight.

If it was as simple as a few side effects versus malaria it wouldn't even be in question.

There may be some drug-resistant strains in the area, but they co-exist with other, responsive strains.

I say again; it's your call.

The risk is too big to just go with citronella and long sleeves. I grew up in Africa and know how serious malaria can be, even more so in children.

If you are near London, visit the Travel Clinic of the Hospital for Tropical Diseases (here). Surprisingly, they are not more expensive than other places.

As they do this for a living, we always use them instead of gp's or commercial travel clinics, as there are doctors trained in these specific areas on site for any queries. My son has asthma, for example, and they always go and double check with a consultant about how he will interact with something or what would be best for him, so not just taking general advice. They also take into account the exact locations you are visiting, and it has happened (but for yellow fever) that the official advice was injections, but that the towns we were visiting were in fact safe, so they recommended not to due to his age.

Oh, and in answer to your original question - we have always bought Malarone Paediatric with full instructions on how to use at first signs (so we never actually gave them, but would if uncertain). You do need to see a doctor about this though, it's not something you can take internet advice on. People die from malaria every day.

Thank you, that's really helpful. My husband grew up in Kenya and spent every Christmas in Diani (which is where we're going). They did always take malarials. My daughter is having a yellow fever jab on weds. They said if you're staying in Nairobi/Mombassa you don't need it but if you go out of the town you do.

I phoned the travel clinic but just got a recorded message. Perhaps I should just walk in!

So just to get a better understanding, you take malarone with you but don't give it unless they start a fever etc? I will mention this on Wednesday. I did hear that if they get malaria having taken the drugs it's harder to fight.

Would be much easier not to go, but my husband is a very patriotic Kenyan!

The usual usage is to take in advance, but where other factors make that risky, they do sometimes, as in our case, recommend that you keep it with you at all times, and at the first sign that they might have malaria (cold symptoms, if I remember correctly - but do check with professionals first), take a specific, stronger dose. We've never had to use it, but always buy just in case.

Anti-malarial such as Malarone can be used two ways:

a) as prophylaxis, and to get the protection you must take it for the specified time before and after your time in the malarial area.

b) as treatment if you have caught malaria (you would use a different drug for treatment than had been used for prophylaxis, or any drug if you had not been taking prophylaxis).

Malaria starts with a temperature and flu-like symptoms. If you do not take prophylaxis, you should bear in mind that falciparum malaria onset peaks at 3-6 weeks post-exposure (and can go out longer), and vivax up to 6 months.

Bramfield I'm in Kenya and know Diani well. This time of the year is prime malaria time at the coast. If you were in Nairobi you wouldn't need to take anything as we are at a higher altitude.

The baby can take Malarone as a prophylaxis from about 12kgs I think. I recommend you start a couple of days before travelling. The most difficult thing is getting the baby to take the tablets! We found hiding them in a spoonful of yoghurt the most effective at this age.

I would recommend you give the baby Malarone as a prophylaxis as many other illnesses have the same symptoms as the start of malaria, it is difficult to diagnose and can easily be missed. The most common strain here is falciparum, which can be fatal.

Fwiw, we are just back from a wonderful 5 days at the coast, with no bites at all.