Malaria and malarial prophylaxis for Kilimanjaro

You are highly unlikely to contract malaria on Kilimanjaro, which is too high and cold for the anopheles mosquito (the species that carries malaria). Nevertheless, Malaria is a problem in Tanzania, which is considered one of the highest risk countries in the world. Malaria is particularly rife in coastal areas and on Zanzibar. There’s even some cases just south of Moshi.

When beginning a course of anti-malarials for Tanzania, it is very important to begin taking them before you go; that way the drug is established in your system by the time you set foot on Tanzanian soil and it will give you a chance to see if the drug is going to cause a reaction or allergy. Once started, complete the full course, which usually runs for several weeks after you return home.

Which anti-malarial you need depends on which parts of Africa you are visiting and your previous medical history. Your doctor will be able to advise you on what drug is best for you. With Tanzania in the highest risk category, the chances are you will be recommended either Lariam (the brand name for mefloquine, Doxycycline or most probably Malarone, which is supposedly free of side effects but very expensive. Stories of Lariam causing hallucinations, nightmares, blindness and even death have been doing the rounds in travellers’ circles for years now but if you feel no adverse reaction – and millions don’t – carry on taking them and don’t worry. Incidentally, there is some anecdotal evidence that taking malarone can affect the efficacy of Diamox. Ask your doctor if he has any views on this.

Of course the best way to combat malaria is not to get bitten at all. A repellent with 30% Diethyltoluamide (DEET) worn in the evenings when the malarial anopheles mosquito is active should be effective in preventing bites. Some use it during the day too, when the mosquitoes that carry yellow and dengue fevers are active. Alternatively, you could just keep covered up with long sleeve shirts and long trousers, sleep under a mosquito net and burn mosquito coils; these are available within Tanzania.

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