Travel Reference
In-Depth Information
ยป D - Diagnosis. If you have a fever or flu-like illness within a year of travel to a
malarial area, malaria is a possibility and immediate medical attention is neces-
sary.
SYMPTOMS
The early stages of malaria include headaches, fevers, generalised aches and pains, and
malaise, which could be mistaken for flu. Other symptoms can include abdominal pain,
diarrhoea and a cough. Anyone who develops a fever in Tanzania or within two weeks
after departure should assume malarial infection until blood tests prove negative, even if
you have been taking antimalarial medication. If not treated, the next stage could develop
within 24 hours, particularly if falciparum malaria is the parasite: jaundice, then reduced
consciousness and coma (also known as cerebral malaria) followed by death. Treatment
in hospital is essential, and the death rate might still be as high as 10% even in the best
intensive-care facilities.
SIDE EFFECTS & RISKS
Many travellers are under the impression that malaria is a mild illness, that treatment is
always easy and successful and that taking antimalarial drugs causes more illness through
side effects than actually getting malaria. Unfortunately, this is not true. Side effects of the
medication depend on the drug being taken. Doxycycline can cause heartburn and indiges-
tion; mefloquine (Lariam) can cause anxiety attacks, insomnia and nightmares and (rarely)
severe psychiatric disorders; chloroquine can cause nausea and hair loss; and proguanil can
cause mouth ulcers. These side effects are not universal and can be minimised by taking
medication correctly, eg with food. Also, some people should not take a particular antim-
alarial drug, eg people with epilepsy should avoid mefloquine, and doxycycline should not
be taken by pregnant women or children younger than 12.
If you decide that you really don't want to take antimalarial drugs, you must understand
the risks and be obsessive about avoiding mosquito bites. Use nets and insect repellent, and
report any fever or flu-like symptoms to a doctor as soon as possible. Some people advoc-
ate homeopathic preparations against malaria, such as Demal200, but as yet there is no con-
clusive evidence that this is effective, and many homeopaths do not recommend their use.
Malaria in pregnancy frequently results in miscarriage or premature labour and the risks to
both mother and foetus during pregnancy are considerable. Travel in Tanzania when preg-
nant should be carefully considered.
STAND-BY TREATMENT
If you will be away from major towns, carrying emergency stand-by treatment is highly re-
commended, and essential for travel in remote areas. Be sure to seek your doctor's advice
before setting off as to recommended medicines and dosages. However, this should be
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