bike touring resources:: dealing with malaria

Tips from a two-time malaria survivor

Malaria is a serious issue for anyone traveling in sub-Saharan Africa, even more so for cyclists who will spend considerable time in villages and away from major medical centers. Your best defense is a good mosquito net, liberal use of repellent and covering exposed areas as soon as the sun starts going down. You'll also probably want to take prophylactics. These are drugs that guard you against the disease, but are never 100% effective. Newl resistant strains of malaria are cropping up all the time so you have to stay abreast of the situation.

We're not medical experts, but we have decided to share what we've learned about malaria in hope of leading you in the right direction. Be sure to contact your local Tropical Disease Center to get advice from a specialist.

here’s what we’ve learned

Some medical professionals may tell you that you'll build up a resistance to malaria after having spent an extended period of time in a malaria zone. As far as we can tell this is absolute rubbish, because locals from Senegal to Malawi all complain of being effected by the sometimes deadly illness. Lariam, a once popular anti-malarial, has a reputation for causing serious side-effects such as nightmares, paranoia, and in extreme cases, irreversible mental-illness. We decided those side-effects weren't worth the risk. Chloroquine alone is another option, but only in regions categorized by the WHO as zone 1 (low resistance, eg Morocco, Egypt). In zone 2 (medium resistance, eg Mauritania and northern Senegal) one can take a combination of chlorquine plus proguanil, which is what we did. In zone three regions (high resistance, all other countries up to Zambia) we took a daily 100mg dose of doxycycline, which is actually an anti-biotic. One major side-effect of doxycycline is that it can make you more sensitive to sun. Fortunately, we didn't have this problem.

Anti-malarials can be very expensive when purchased in Europe or North America. We bought all medicines in Africa, where they are readily available and cost a fraction of what you pay in the West. Although there have been recent scares about fake drugs flooding the markets in Africa, most reputable pharmacies will stock drugs imported from India (one of the world's largest producers of pharmaceuticals) which are often manufactured in cooperation with a reputable Western pharmaceutical company.

watch out for these symptoms
It's not always easy to know if you've got malaria, especially if you're taking prophylactics because these drugs may mask symptoms. Here is a list of symptoms associated with malaria:

fever
chills
sweats
headache
body aches
nausea and vomiting
fatigue

Malaria symptoms will occur at least 7 to 9 days after being bitten by an infected mosquito.
Malaria may cause anemia and jaundice. Malaria infections with Plasmodium falciparum, if not promptly treated, may cause kidney failure, coma, and death. Some travelers may still develop malaria up to a year after returning from a malarious area.

get help
See a doctor immediately if you develop malaria-like symptoms. In many cases medical help may not be available, so it is imperative that you carry an emergency treatment. We carried a supply of coartum. If you fall ill and suspect it's malaria, you can use coartum for emergency self-treatment. Just follow the usual dosage instructions printed on the package. Even if you can find a doctor, in many out of the way places it’s unlikely that medical professionals will have malaria testing kits. Most medical professionals in Africa usually just assume it's malaria if you've got a high fever. Simple-to-use self testing kits for malaria are available in Europe and North America, so you may buy a couple before you head off on your trip.

We both came down with a mild form of malaria twice. It was not the crisis we had imagined. There was certainly no need to wonder if the travel insurance covers medical evacuation. We were overcome with a heavy fatigue, listlessness and high fever. But just a couple of days after beginning the treatment we felt better and were able to get back on the bikes. We were lucky, but malaria can be fatal so do take any symptoms seriously.

Check out the Center for Disease Control for country-by-country specific health information.

We are not medical experts. The information provided here is based on our personal experiences only and should not be considered medical advice. Consult a physician for all questions concerning malaria and other medical issues.

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