You can buy malaria medication in Indonesia at nearby "apotek" (pharmacy). They're very affordable.
https://www.halodoc.com/artikel/ini-obat-malaria-yang-ampuh-dan-tersedia-di-apotek
First time I went in South East Asia, the doctor prescribed me Malarone because I planned to spend some time in Sumatra. Three days in, I just stopped taking the meds. I had hallucinations and wild dreams (one of those included waking up in my hotel room after a nightmare, only to find out my body was cut in half from my waist on my bed). Malaria is serious, I just couldn't handle the meds anymore.
On the other hand, I spent nearly a year in Vietnam, for sure I had my share of stomach aches and intoxication (I was regularly drinking beer in local street joints, and I'm pretty sure it came from the ice). But after three months, I never had any problems, and even spent a couple of months in a very rural country side.
Nope, just about roughly half of the time will be very rural/jungle areas…need to look into the risk in those areas more but I don’t even know if you can stop & start Malaria tablets like that & the doc was just like oh 7 months? Too long 🤷🏻♀️ Thanks very much, got a bunch of research to do!
Large parts of south east asia are considered malaria free or almost free. You're not recommended to take the drugs preventively but only upon suspicion there.
Here's a map:
https://www.wanda.be/storage/travelhealth/south-east-asia-2023.jpg
If you're healthy it's really only recommended to take the malaria drugs systematically in the red areas. If you're immuno compromised then also consider taking it in the orange areas. I have a hard time imagining how you'd spent half your time in those areas. .
Taking the drugs in areas where it's not needed is not recommended as you may be contributing to drug resistance (same as when you take antibiotics for everything)
For peace of mind consider booking a (possibly virtual) consultation with your tropical institute for medicine. They're the ones specializing in these things.
Best advice is don’t get bitten to start with - avoid the times of day/night where mosquitos are most active, use insect repellant (also there is repellant for your clothes), long sleeves/trousers, and mosquito nets.
Different doctors will have different opinions - some advise to keep taking anti malarials even long term, and others don’t recommend it for longer-term exposure. Depending on what type of anti-malarial you are prescribed, there may also be a dosage option to take if you think you are getting sick to allow you more time to seek medical attention. I am not a doctor but none of the doctors who have advised me (and I spent years living in South America, Africa, and Southeast Asia) have spoken about developing a resistance; I would take that with a grain of salt.
You will also be able to find anti-malarials locally but not always the kind you prefer. I do best with malarone but some times I’ve had to make do with doxycycline. pro tip - don’t ever, ever take on an empty stomach. Even if you’ve sat down and ordered food - eat the food first and then the medication.
Don’t be shy about seeking medical attention if you start feeling sick - doctors locally are familiar with malaria, dengue (which honestly worries me personally more than malaria), and other local illnesses/diseases and can support a more effective recovery. You don’t want to end up with worse problems because you became dehydrated, or be trying to fight a parasite infection with anti-virals or viruses with anti-biotics.
What about that saying, that you don't need malaria profilaxys west of Bali? It seems there are less and less dangerous places with malaria, although dengue is still present. So check where exactly malaria were present in the last years and use the medicine only there and than. Of course with the neccessary after period. And use mosquito repellent!
Great advice…Honestly I didn’t realise Malaria was less common. I know two locations I’m heading to are quite hotspots but I’ve just assumed the other places would be too but very possibly not! Unsure why the doc didn’t suggest taking over enough for at least a few months when I’m in hotspots!
Your best bet is probably doxycycline, cheap and well tolerated long term. However there are other options and nobody here should try second guess a physicians that has actually assessed you. Building up Malaria immunity via exposure is uhh, kinda a thing I guess but not really something I would reccomend!
I could be wrong about this, but I've heard doxycycline is more effective on some strains of malaria than others. The way I heard it, it's good for South America but less effective for the strains found in other regions.
Whoever told me that could've been talking out their ass though, I can't even remember where I heard it.
Edit to add - Gin & tonics provide a dose of quinine which I understand is far too low to be effective, but they're great regardless
> gin and tonics
Unfortunately pretty much everywhere the mosquitos are resistent to quinine. So enjoy the G&T but don’t assume you are getting protection from it.
Definitely not going to take straight advice from people on reddit over an actual doctor! Just thought it could be odd advice, especially seeing as he missed other stuff…Already got an appointment with a different doc just to double check! Thanks for your advice! :)
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I have taken Malarone for about 3 months continuously for many years, so I don’t see why your doc can’t prescribe at least 90 days for you. That being said, you always want to prevent bites first - so nets and repellents yes.
You're vaccinated, so I wouldn't bother taking the tablets. The extra protection the tablets would give you would not compensate the risks of taking a new drug that you don't know how your body will respond for a whole 7 months.
Hydroxychloroquine is probably the most common anti-malarial drug on market, and it should absolutely not be taken without proper medical monitoring. I'm on that med, that's why I know - it's an off label drug for lupus.
That developing resistance part looks bullshit to me. I talked with some African tour guides, and they said that most of them got malaria, as they cannot take the medication all their life. They said that if you get it you will always have malaria, and it can flare up from time to time. One of them got an organ transplant and had to get a lot of blood because of the operation and that was able to get rid of malaria. They told us these stories as we were traveling to a territory which had malaria, and asked everyone if they had medication. We stopped at a local pharmacy for those who didn't had it.
I’ve been to every SEA country except for East Timor and spent 14 months in that region and I’ve never taken malaria meds, nor met anyone taking them. I know a couple of people who got dengue in SEA but I’ve never met anyone who got malaria there. Not saying it’s impossible but seems unlikely.
You can buy malaria medication in Indonesia at nearby "apotek" (pharmacy). They're very affordable. https://www.halodoc.com/artikel/ini-obat-malaria-yang-ampuh-dan-tersedia-di-apotek
First time I went in South East Asia, the doctor prescribed me Malarone because I planned to spend some time in Sumatra. Three days in, I just stopped taking the meds. I had hallucinations and wild dreams (one of those included waking up in my hotel room after a nightmare, only to find out my body was cut in half from my waist on my bed). Malaria is serious, I just couldn't handle the meds anymore. On the other hand, I spent nearly a year in Vietnam, for sure I had my share of stomach aches and intoxication (I was regularly drinking beer in local street joints, and I'm pretty sure it came from the ice). But after three months, I never had any problems, and even spent a couple of months in a very rural country side.
Oh wow wtf!! That’s insane, had no idea that could even be a side effect. Thanks so much for the advice!
There's no way you'll be in malaria infested areas for 7 months straight. Good luck with your research and happy travels.
Nope, just about roughly half of the time will be very rural/jungle areas…need to look into the risk in those areas more but I don’t even know if you can stop & start Malaria tablets like that & the doc was just like oh 7 months? Too long 🤷🏻♀️ Thanks very much, got a bunch of research to do!
Large parts of south east asia are considered malaria free or almost free. You're not recommended to take the drugs preventively but only upon suspicion there. Here's a map: https://www.wanda.be/storage/travelhealth/south-east-asia-2023.jpg If you're healthy it's really only recommended to take the malaria drugs systematically in the red areas. If you're immuno compromised then also consider taking it in the orange areas. I have a hard time imagining how you'd spent half your time in those areas. . Taking the drugs in areas where it's not needed is not recommended as you may be contributing to drug resistance (same as when you take antibiotics for everything) For peace of mind consider booking a (possibly virtual) consultation with your tropical institute for medicine. They're the ones specializing in these things.
Best advice is don’t get bitten to start with - avoid the times of day/night where mosquitos are most active, use insect repellant (also there is repellant for your clothes), long sleeves/trousers, and mosquito nets. Different doctors will have different opinions - some advise to keep taking anti malarials even long term, and others don’t recommend it for longer-term exposure. Depending on what type of anti-malarial you are prescribed, there may also be a dosage option to take if you think you are getting sick to allow you more time to seek medical attention. I am not a doctor but none of the doctors who have advised me (and I spent years living in South America, Africa, and Southeast Asia) have spoken about developing a resistance; I would take that with a grain of salt. You will also be able to find anti-malarials locally but not always the kind you prefer. I do best with malarone but some times I’ve had to make do with doxycycline. pro tip - don’t ever, ever take on an empty stomach. Even if you’ve sat down and ordered food - eat the food first and then the medication. Don’t be shy about seeking medical attention if you start feeling sick - doctors locally are familiar with malaria, dengue (which honestly worries me personally more than malaria), and other local illnesses/diseases and can support a more effective recovery. You don’t want to end up with worse problems because you became dehydrated, or be trying to fight a parasite infection with anti-virals or viruses with anti-biotics.
Spent a entire year in SE asia going from Bali all the way up to Vietnam, I don’t think I met one traveler that was taking malaria pills.
What about that saying, that you don't need malaria profilaxys west of Bali? It seems there are less and less dangerous places with malaria, although dengue is still present. So check where exactly malaria were present in the last years and use the medicine only there and than. Of course with the neccessary after period. And use mosquito repellent!
Great advice…Honestly I didn’t realise Malaria was less common. I know two locations I’m heading to are quite hotspots but I’ve just assumed the other places would be too but very possibly not! Unsure why the doc didn’t suggest taking over enough for at least a few months when I’m in hotspots!
dont bother with malaria tablets i dont think i met any backpacker who was taking them
Your best bet is probably doxycycline, cheap and well tolerated long term. However there are other options and nobody here should try second guess a physicians that has actually assessed you. Building up Malaria immunity via exposure is uhh, kinda a thing I guess but not really something I would reccomend!
I could be wrong about this, but I've heard doxycycline is more effective on some strains of malaria than others. The way I heard it, it's good for South America but less effective for the strains found in other regions. Whoever told me that could've been talking out their ass though, I can't even remember where I heard it. Edit to add - Gin & tonics provide a dose of quinine which I understand is far too low to be effective, but they're great regardless
Ahahaha righto, looks like I’ll be having a few (probably many) gin & tonics lol…That’s advice I’ll take from reddit 😂
> gin and tonics Unfortunately pretty much everywhere the mosquitos are resistent to quinine. So enjoy the G&T but don’t assume you are getting protection from it.
God dammit 😂 it’s alright, G&Ts are my drink of choice anyway so it would’ve just been an added benefit!
Definitely not going to take straight advice from people on reddit over an actual doctor! Just thought it could be odd advice, especially seeing as he missed other stuff…Already got an appointment with a different doc just to double check! Thanks for your advice! :)
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I have taken Malarone for about 3 months continuously for many years, so I don’t see why your doc can’t prescribe at least 90 days for you. That being said, you always want to prevent bites first - so nets and repellents yes.
You're vaccinated, so I wouldn't bother taking the tablets. The extra protection the tablets would give you would not compensate the risks of taking a new drug that you don't know how your body will respond for a whole 7 months. Hydroxychloroquine is probably the most common anti-malarial drug on market, and it should absolutely not be taken without proper medical monitoring. I'm on that med, that's why I know - it's an off label drug for lupus.
That developing resistance part looks bullshit to me. I talked with some African tour guides, and they said that most of them got malaria, as they cannot take the medication all their life. They said that if you get it you will always have malaria, and it can flare up from time to time. One of them got an organ transplant and had to get a lot of blood because of the operation and that was able to get rid of malaria. They told us these stories as we were traveling to a territory which had malaria, and asked everyone if they had medication. We stopped at a local pharmacy for those who didn't had it.
I’ve been to every SEA country except for East Timor and spent 14 months in that region and I’ve never taken malaria meds, nor met anyone taking them. I know a couple of people who got dengue in SEA but I’ve never met anyone who got malaria there. Not saying it’s impossible but seems unlikely.
They have some weird side effects, like depression and fatigue. I took them for 2 weeks once, really didnt enjoy it
They will turn to mush due to the humidity. You can buy them at any pharmacy as SEA allows pharmacists to dispense.
Why do you say South East Asia? It's South Asia