Travelling to malaria-risk areas

Hylton Mallach of M-Kem 24-hour Medicine City.

I mention this as I have travelled to malaria-risk areas before and not taken anti-malarial prophylaxis and I want to warn you against doing the same.

One person in our party travels frequently in high-risk areas and rather than use preventative medication, he carries a malaria treatment dose with him which he says you can get from a doctor before you travel.

I was very happy to have taken Malanil, although the most costly of the tablets available, I had no side-effects and found the pill-popping regimen of one tablet before I left, one every day while away and then one daily for a week on return pretty simple to follow.

Hylton Mallach, pharmacist and founder of M-Kem 24-Hour Medicine City, explains that atovaquone and proguanil hydrochloride work to disrupt the creation of pyrimidines which are needed for malaria to replicate. Sister Joy Thompson runs the M-Kem Travel clinic and says that mosquitos transmit both malaria and yellow fever.

"Many African and tropical counties will not allow travellers to enter unless they have been immunised against Yellow Fever and have a card to prove it," she says, explaining the value in visiting a travel clinic.

Recommended vaccinations

For our trip to Madagascar, where I knew we would be kayaking and trekking in mountain and rainforest areas, I asked Sr Thompson to recommend vaccinations. I had had a Yellow Fever shot previously but got immunised against Typhoid, Hepatitis and also the flu virus. I did start to feel a bit like a pin cushion but she spread the jabs over two arms and, other than a mild headache later in the day, I wasn't aware of any symptoms as a result of having had my shots. She also recommended a four-in-one product Adacel Quadra which protects against tetanus, polio, diphtheria and whopping cough which, she tells me, is on the increase in adults.

One sure way to feel unwell is to read the package insert that comes with your meds. What is rather alarming is how many very serious conditions (I'm thinking Malaria and Hepatitis) begin with flu-like symptoms. Although I've returned from Madagascar in fine fettle, I'm very, very pleased that my doctor prescribed a batch of antibiotics to take along with me in case I became ill. Lomotil or similar against the runs is also recommended and, best thing of all, packets of anti-bacterial wipes. Even after washing my hands with soap and water, I'd use a wipe before eating. Only use bottled water (and not ice unless it is made from bottled water) in Madagascar, even to rinse your toothbrush. The regular traveller among us wouldn't even eat salads (although we were told that all restaurants in Madagascar use chlorine in the water that rinses vegetables and leaves) and I had no side effects from ingesting my greens.

I always carry a mini first-aid kit with me and was very glad for it as I needed to extricate a wooden splinter from deep inside a fellow traveller's foot. Having antiseptic wipes, antiseptic ointment, tweezers and something sharp to cut in to the skin is essential. I had needles and cotton which I used but will pack disposal lancets next trip.