3

I'll be visiting Myanmar during February and March and was wondering how necessary is for me to take Malaria pills (I heard about nasty side effects).

I will not go camping or sleeping outside but will visit country side and go trekking.

5

The nasty side effects are more likely from mefloquine than from atovaquone/proguanil or doxycycline. Given "trekking" you should definitely take prophylaxis - and be sure to start the course before you arrive in Myanmar.

I (no doctor!) would advise against mefloquine, though that is cheaper. The side effects can be nasty (in my case vision quite badly affected for a month or so, and possibly mildly for years thereafter). This was not from the first couple of times I took Lariam (tm) (no longer even sold in USA) and in case there is any build-up effect it may be best to save it for where it is the only recommended drug.

From fitfortravel:

If travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby treatment may be considered.

CDC advice (2017) regarding malaria in Myanmar is, as well as check with your doctor:

Areas with malaria: Present at altitudes <1,000 m (3,281 ft), including Bagan. Rare transmission above 1,000 m.

Estimated relative risk of malaria for US travelers: Moderate.

Drug resistance4: Chloroquine and mefloquine.

Malaria species: P. falciparum 60%, P. vivax 35%, P. malariae, P. ovale, and P. knowlesi rare.

Recommended chemoprophylaxis: In the provinces of Bago, Kachin, Kayah, Kayin, Shan, and Tanintharyi below 1,000m (3,281 ft): Atovaquone-proguanil or doxycycline. All other areas with malaria: Atovaquone-proguanil, doxycycline, or mefloquine.

Note 4: Refers to P. falciparum malaria unless otherwise noted.

  • yeah thanks buddy, i will still check with the doctor of course but it is good to be well informed and hear if others had some experience with the drugs before popping the pills – user981916 Nov 24 '14 at 13:31
  • @user981916 atovaquone&proguanil (aka Malarone) has very rare mild side effects, the main side effect is on the wallet. I've been in a malarial country on/off for 18 months, most foreigners here take it, never heard of anyone having a bad reaction (though people usually change after 6 months or so because it's not confirmed safe for very long times)... – user568458 Feb 13 '17 at 9:28
  • ...Many people here take doxycycline, and I've taken it almost non-stop for 18 months, and again never heard of any problems. It's very cheap, most common side effect is "sensitivity to sunlight" which I get but it's fine, basically your skin goes red before it burns which is great because it's like an early warning! Stomach sometimes feels funny a few hours after taking it, and some people say they feel a little sick if they take it with dairy, but this is very mild. – user568458 Feb 13 '17 at 9:30
  • pnuts is 100% right that anti-malarials' bad reputation comes almost entirely from mefloquine (aka Larium). Don't touch that s&*t with a pole! Some people find it okay and wonder what the fuss is about, but some people get serious mental health side effects (and worse, some people do but don't even realise what's happening or why). "Friends don't let friends take Larium" – user568458 Feb 13 '17 at 9:32
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There are the old stand by's. Gin & tonic. Purple bark if you know a witch doctor. But I would advise it for most who wish to go there.

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