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23 years
Please i need to know the side effects of lariam (anti malaria drug). for how long is it safe to take it? what other vaccins should i take before going to africa?
Aug 7, 2014

Dr. Zakia Dimassi Pediatrics
When your destination of travel is the African continent, you need the following medical precaution measures, according to the center for disease control and prevention (CDC):
1- Yellow Fever vaccination
2- Malaria prevention:
Malaria in humans is caused by a parasite. Infection occurs 1 of 4 species of the genus Plasmodium: Plasmodium falciparum, P. vivax, P. ovale, or P. malariae.
All species are transmitted by the bite of an infective female Anopheles mosquito. Occasionally, transmission occurs by blood transfusion, organ transplantation, needle sharing, or congenitally from mother to fetus.
Malaria preventon:
-Mosquito Avoidance Measures
Malaria transmission occurs primarily between dusk and dawn because the Anopheles mosquitoes like to feed at that time of the day. Contact with mosquitoes can be reduced by remaining in well-screened areas, using mosquito bed nets (preferably insecticide-treated nets), using an effective insecticide spray in living and sleeping areas during evening and nighttime hours, and wearing clothes that cover most of the body.
All travelers should use an effective mosquito repellent applied to exposed parts of the skin when mosquitoes are likely to be present. If travelers are also wearing sunscreen, sunscreen should be applied first and insect repellent second. Also advisable is the application of a permethrin-containing product to bed nets and clothing for additional protection against mosquitoes.
-Chemoprophylaxis (taking medications for prophylaxis):
All recommended primary chemoprophylaxis regimens involve taking a medicine before, during, and after travel to an area with malaria. Beginning the drug before travel allows the antimalarial agent to be in the blood before the traveler is exposed to malaria parasites. Lariam (mefloquine) is indicated for the prophylaxis of P. falciparum and P. vivax malaria infections, including prophylaxis of chloroquine-resistant strains of P. falciparum; it is the drug of choice for prevention especially that it covers resistant malaria strains.
Dosage: One 250 mg Lariam (mefloquine) tablet once weekly.
Prophylactic drug administration should begin 1 week before arrival in an endemic area. Subsequent weekly doses should be taken regularly, always on the same day of each week, preferably after the main meal. To reduce the risk of malaria after leaving an endemic area, prophylaxis must be continued for 4 additional weeks to ensure suppressive blood levels are maintained. Tablets should not be taken on an empty stomach and should be administered with at least 240 mL of water.
The most frequently reported side effects of mefloquine at this dose include: vomiting (3%). Dizziness, syncope, extrasystoles and other complaints (<1%) were also reported.
3- Hepatitis B vaccine booster dose: you have received 3 or 4 doses of this vaccine as a child, but you need a booster shot to remind your immune system's memory on how to fight against the Hepatitis B virus (especially recommended for people who work in the healthcare field or those with risky behaviors, like unprotected sexusal activities)
4- Typhoid booster shot: this vaccine was also part of your childhood vaccine series, but, and like any other adult even if not traveling to Africa, you need a booster shot, particularly if you're going to areas with increased risk of exposure, especially in smaller cities, villages, or rural areas and for people who like to have culinary adventures with exotic foods.
5- Ebola virus:
Due to the recent outbreak of the Ebola virus in Africa, it is useful to adopt the following precautions, knowing that there is no vaccine or specific treatment for Ebola. The CDC recommends the following:
-Vigorous hygiene: Avoid contact with blood and body fluids. Do not handle items that may have come in contact with an infected person’s blood or body fluids.
-Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
-Avoid contact with animals or with raw meat.
-Avoid hospitals where Ebola patients are being treated.
-Seek medical care immediately if you develop fever, headache, body aches, sore throat, diarrhea, vomiting, stomach pain, rash, or red eyes.
-Limit your contact with other people when you travel to the doctor. Do not travel anywhere else.
-Pay attention to your health after you return.
-Monitor your health for 21 days if you were in an area with an Ebola outbreak, especially if you were in contact with blood or body fluids, items that have come in contact with blood or body fluids, animals or raw meat, or hospitals where Ebola patients are being treated.