Arusha Tanzania 2006 Day 10 - Malaria
Malaria is an interesting bug. Lots of locals blow it off. "Sure, I've had malaria a number of times, sometimes every few months, but then I kick it in a month or two." However, it does kill 2 million a year, and if you do survive it's no fun to have. My mother-in-law just got it after only 3 months in Tanzania after moving from Zimbabwe. There's a lot less incidence of Malaria in Zim than in TZ.
Malaria kills more than 2 million people in Africa each year. Between 300 and 500 million people suffer from malaria, the majority of which are young children; one out of 20 children in Africa dies of malaria before the age of 5. Families are often forced to spend approximately 20% of their income on malaria treatments, and public health institutions spend up to 40% of their budgets on outpatient malaria treatment. All told, in addition to the human loss and suffering, the disease results in an economic loss of $3 billion to African economies each year, slowing economic growth by approximately 1.3% annually. [SDP.org]
Here's what we're doing to prevent malaria while we're here. It's a fairly aggressive and multi-pronged series of techniques. Some may call it overkill, I call it thorough. We're fortunate enough to have enough money to be this thorough, although using any one of these techniques is better than doing nothing and taking your chances.
- Mosquito Nets
- Treated Mosquito Nets with Permethrin - You can use a standard Mosquito net, but I recommend taking it to the next level and treating the nets with a repellent. There are some concerns about Permethrin as it's technically a carcinogen, but for a short time, I'm willing to take the risk. We soaked our Mosquito nets in backs with Permethrin for a half-day before we came.
- Treated Clothing
- You can also treat clothing with Permethrin. We treated our jeans and shirts. It's a simple treatment. You pour the liquid into a bag, with 2 parts water to 1 parts Permethrin, shake, then wait for a few hours, then dry. You can buy pre-treated clothes, but that's a lot of money for something that will only last for 6 weeks or 6 washings.
- Citronella Candles
- Citronella smells pleasant enough, but apparently bugs don't like it. You can buy candles and smoking coils that will keep bugs out of your room.
- Bounce Fabric Softener
- You can just wipe these on a baby's clothes, and the rumor is that bugs will stay away. No proof yet.
- Medical - Oral
- Malarone anti-malarial
- This is one of the more expensive and newer anti-malarials, but the cheaper ones like Mefloquine and Cloroquine are working less and less as the mosquitos are getting resistance. If you get malaria while you're on one of these anti-malarials it'll be a lot more difficult to treat. Malorone has fewer side effects than most any anti-malarial out there. When I was taking Mefloquine I had some horrible night-terrors - a common side effect. None of us, including Z, who had a specially compounded baby-dose of Malarone, have had any side effects. You'll need a prescription, and it won't be cheap.
- UPDATE: There have been reports of VERY bad side effects from Mefloquine (Lariam) so do be aware of that.
- Artemisinin - homeopathic anti-insect
- This concentrated dose of "sweet wormwood" is supposed to make you less tasty to the mosquito. It's used to treat Malaria, but folks are starting to use it for a prevention. It's been used in China and outside the US, and is starting to get some attention in the US. You shouldn't use it for a long period of time as it can eventually bother the liver, but I've spoken to folks who've traveled in sub-Saharan Africa who swear by it. You don't need a prescription, but it may be hard to find, or behind the counter.
- 100mg of Vitamin B
- Loading up on Vitamin B can hurt the liver if you take it too long, but it also makes you less attractive to bugs.
- Medical - Topical
- Deet creams
- We got a combination cream that is 20% deet and includes an SPF 20 Sunblock in one cream for convenience. If you're in Africa, get something with at least 20% deet, or more if possible. It's not something you should put on baby's face though, or anywhere that she might touch with her hand then put it in her mouth.
- Citronella creams
- Citronella creams are safer than Deet for children, and if you're not into Deet or if you're anti-chemical, a citronella-based cream is a reasonable alternative, although arguably less effective.
We haven't been bitten yet.