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Malaria tablets and pregnancy

London, United...
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Malaria tablets and pregnancy

Booked a 2 week self drive safari leaving on 29 april 2009. Since found i am pregnant and would be 19 weeks at that point. We have a fully equipped 4x4 and will be in a combination of campsites and lodges during the trip.

I am getting conflicting medical advice about taking malaria tablets. Trailfinders Travel Clinic is happy to prescribe Larium in 2nd trimester, MASTA travel clinic would not prescribe anything.

Would be in Etosha and then Waterberg for last 5 days of the trip.

Anyone had any experience of being pregnant in a malarial region.

Before I have to change my plans, anyone have any thoughts?

Isle of Man, United...
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1. Re: Malaria tablets and pregnancy

You should consult your local GP. He/She is the one who knows you best. You should not take Larium if their is any medical history of "Nervous or Psychiatric problems."

To specifics..

April is the end of the rains so there will still be Mossies about. Etosha and the Waterberg are far enough north to warrant prophylactics. 5 Days is not long to run the risk of an infected bite.

Do you feel,lucky?

Bath UK
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2. Re: Malaria tablets and pregnancy

Oh goodness, that's a hard one.

Unknown to me, I was in early stage pregnancy when taking Malarone in Gambia 2 years ago. There are no obvious side effects NOW (but who knows) and my doctors weren't too bothered during the rest of my pregnancy....BUT DO ASK as many experts as you can find (I can't imagine that there are too many volunteers for 'taking malarials whilst pregnant' trials) but it must be a problem for lots of affluent women around the world.

Maybe try to find some SA doctors who are used to dealing with malaria prevention rather than a UK travel clinic.

The efficacy of anti-malarials DOES change (this is an old site), but this site suggests that you ought to be able to find some advice in Namibia

http://etosha.com/malaria.htm

What would I do second time around if I had realised I was pregnant?......Hmm...probably change a Namibia itinerary to stay out of the malarial zone and enjoy Swakopmund, the red dunes.......there is so much to see in Namibia. It's still beautiful.

I don't envy your choice.

Pickering, United...
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3. Re: Malaria tablets and pregnancy

The following document gives current advice from the South African Dept of health. Page 33 states that mefloquine can be used in the 2nd and 3rd trimesters (4th month onwards). This is the trade name for larium. This appears to support the advice from trailfinders.

London, United...
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4. Re: Malaria tablets and pregnancy

safarifiend - was there a link i could look at? just googled but can't seem to find the document you are referring to.

Thanks for everyone's thoughts so far. It was my GP who advised me to seek out specialist advice, otherwise she is happy for me to go.

Isle of Man, United...
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5. Re: Malaria tablets and pregnancy

Of your GP is happy then do it.

Stanley, Falkland...
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6. Re: Malaria tablets and pregnancy

It would be interesting to know why MASTA wouldn't prescribe anything.

Does that mean they are happy for you to go un- protected? Or do they think you should avoid malarial areas?

IMO, it's simply not worth the risk, and Namibia has so much to offer in malaria-free areas. Instead of watching rhino at a waterhole, you'll be looking over your shoulder for mossies....

Pickering, United...
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7. Re: Malaria tablets and pregnancy

Sorry forgot to copy the link! Obvioiusly in need of a holdiay . . .

malaria.org.za/Malaria_Risk/prophylaxis/prev…

New Zealand
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8. Re: Malaria tablets and pregnancy

I'm sure Lizzie that additonnally to the advice of health professionals,you will be taking all the possible steps to avoid being bitten.

Cover up,long sleeves and trousers, socks, when mosquitoes are flying, usually evenings.

Take a mosquito net.Plenty of insect repellent.If you don't like Deet products, try Avon Brand 'Skin so Soft Bugguard' excellent for repelling mosquitos and other annoying flying bugs.And nicer to uase being a skin tonic .

I was nicknamed 'No flies Jim' after our troup noticed the bugs swarmed around everyone but me.Even kept the mopane bees away.

cambridge, MA
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9. Re: Malaria tablets and pregnancy

Hi LizzieRUk, congratulations on your pregnancy! The New England Journal of Medicine recently published a review of malaria prevention in short-term travelers; here is their (brief) segment for pregnant women, where the data are sparse: "Malaria infection is more severe in pregnancy, and the risks of adverse outcomes (for both the mother and the fetus) are increased. No chemoprophylactic agent is 100% effective. The WHO and the CDC both recommend that pregnant women not travel to areas where malaria is endemic. Most women refrain from traveling to these areas during pregnancy, but for pregnant women who decide to travel or must travel, mefloquine is the drug of choice for chloroquine-resistant malaria (Table 3). Because data are limited on the use of this drug during the first trimester of pregnancy, a delay of the trip to later in pregnancy is recommended if feasible. The use of agents containing 20% DEET has been shown to be safe in pregnancy,29 although agents containing this concentration should be applied frequently because they have a shorter duration of effect than agents with a concentration of 30% or more." You can read the full article here: content.nejm.org/cgi/content/full/359/6/603. Good luck with your travels.

10. Re: Malaria tablets and pregnancy

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