Malaria medication and other shots

More information from Eden Grace:

Now, about malaria medication. This is really important, and chances are your local travel clinic is not as well informed as they should be. There are three options for malaria prophylaxis. All of them have to be started before you travel, and continued for a period of time after you return.

Malarone (Atovaquone/Proguanil combo) -- this pill is taken once per day. It is by far the most effective for malaria prevention, but it is also very expensive (being a new drug not yet off patent). I'm not sure what the health insurance coverage is, but if you can afford Malarone, it's the one I would recommend. The most common side effect is upset stomach, which is greatly reduced if you take the pill with a full meal.

Doxycyline -- this pill is taken once per day. It is an antibiotic, which means it can also prevent travelers tummy, but will trigger a yeast infection in women prone to such. It is effective against malaria, but not quite as good as Malarone. It causes sun sensitivity, so rigorous sunscreen application is a must.

Lariam (mefloquine) -- this pill is taken once per *week*. This used to be the standard option, before Malarone was developed. Some travel docs still use it as their first choice. Some people like the idea of only taking one pill per week. But beware ... lariam causes psychiatric side effects which can be very severe and long-lasting. Nearly everyone who takes it has frightening dreams. The symptoms get worse from there -- insomnia, depression, anxiety and panic attacks, suicidal thoughts, homicidal thoughts, etc. Even people who have "successfully" taken lariam in the past can find themselves triggered into a frightening spiral on their next trip. In my opinion, no one should take this drug. Travel docs will try to give it to you. Please refuse.

Of course, the very best way to prevent malaria is to not get bitten in the first place! The bad news is that you are visiting an area with an extremely high incidence of malaria, so this is a very real issue for travelers. The good news is that the female anopheles mosquito, the one who transmits malaria, only bites during hours of darkness. Therefore, our itinerary will always have us indoors after dark. A DEET-based repellant can be applied at dusk, and you will always be sleeping under insecticide-treated bed nets. Bite prevention is possible, and we will do everything we can to make it happen!

The students will get plenty of opportunity to learn about clinical malaria at the Hospitals -- to see how it is treated and understand how and why it kills 1 in 5 children under 5, and to look at the parasites under a microscope and learn to identify and diagnose malaria. If they want to read up on the complex and fascinating life cycle of the malaria parasite before they get here, all the better!

The other most common diseases they will see in the Hospitals are typhoid, tuberculosis and AIDS. All would be good "extra credit" study topics in preparation for the trip.

Oh, a word about the Yellow Fever vaccine -- technically, it is not required for travel to Kenya if this is your first trip to the 3rd world. However, it is required if you ever travel to another African or Latin American country after having been to Kenya. My recommendation is to get the shot and the yellow WHO booklet (which also serves as an immunization record for all the shots you get for this trip). It is good for 10 years.

Let me know what other questions I can answer!

Blessings,
Eden