malaria in cambodia

[aot871]

Is there any need to take anti malaria pills if only visiting siem reap and phnom penh , according to my local travel both these places are out side the world health area map for malaria, but other sites talk of people taking them

[Beachlover]

Aot871, you need to see a doctor to get professional advice. Don't take advice from this or any other site as there's various factors involved, different strains in different areas and things change. E.g. a place that's clear might become a malaria zone again.

All I can tell you is my experience went like this...

I phoned a retired doctor before my trip and he said his knowledge wasn't current so he would ask some of his ex-colleagues still practicing for the latest advice. He got back to me later and said Phnom Penh is fine but Siem Reap surrounds (i.e. temples) is still a malaria zone, albeit low risk. He prescribe me some Doxy-something, said there may be some side effects and I should stop taking them if I experienced any. He conveniently mailed me the script (I gave him a bottle of wine at our next family gathering) and I got the pills from a chemist.

When I got to Siem Reap, I'd already been taking the pills for a few days and started feeling crap in the stomach. I asked a few local expats about malaria and if they took anything. They all said it was a personal decision as it is a low risk area. They also all said they don't take any themselves and the bigger worry for them was Dengue Fever. So in light of this and the doctor's advice I decided to stop taking them. I also heard the time of the year that you visit can be a factor.

That was my experience but you must see a doctor to get up to date professional advice tailored to yourself.

[jinks]

Personally having had malaria, or still have it but dormant, dependent on your attitude, I find the anti-malaria pills as upsetting to my system as the disease itself.

[Beachlover]

The two most common anti-malarials are Doxy-something and Malarone.

I asked my doctor about why he recommended Doxy in particular and I recall he told me...

(This is just from memory)

- Malarone (or whatever the name is) is more expensive and has greater probability of more serious side effects (I recall reading some nightmare stories about long-term health effects from people who had really bad reactions to it) but you don't have to take as many pills.

- Doxy is cheaper, has less side effects and protects against the most serious strains of Malaria that were present there (I think he said Celebral Malaria). I think it gets prescribed for a lot of other stuff too. I also recall a mate of mine who is in the army said he went to the doctor to get an anti-malarial prescription and the doctor found he was already taking Doxy, prescribed by the army as treatment for acne, so he was just told to keep taking it as this would protect him from malaria anyway.

- My doctor said it's dependent on what strains are prevailant and how prevailant in the area you're going and protecting against the more serious strains takes priority (might not be so lethal if you catch a milder strain).

Others have told me the time of the year also makes a difference. When I visited far North Thailand (I mean, right up against the Burmese border) I didn't bother with them but I met some other travelers who were taking pills as recommended by their doctor. In my opinion, it was really unnecessary there as it was so cold and there were no mozzies around that time of the year.

[lukylok]

We have a "travel clinic" depending of one of our best universities. (Actually the daughter of a previous "colonial clinic" ) :8( . I always go there before going to far away countries in Africa, Asia or South America. They have very updated information about the risks of malaria - and other diseases - and can tell you where you are at risk and not. From my previous visits, there is a risk in Thailand, in Mae Hong Song only or maybe in the deep south. Not in Cambodia if you stay around the Tonle Sap. But it changes, the maps are frequently updated.
I went there last week to check about my vaccines and Myanmar. No risk of malaria in Myanmar, if you are not going in the wilderness, and not along the Thai border (Mae Hong Song again).
Malaria risk varies greatly if you are travelling in hotels, guest houses or roughing it.
This year I got out with a booster injection against tetanos.
I agree with Jinks : treatment against malaria is no fun, but in my experience, malarone is better supported than the others.

[fedssocr]

and you also have malaria strains that are resistant to the drugs. I tried Malarone a couple of times but the side effects were too much for me. Doxycycline is an antibiotic that is sometimes used to treat malaria...but it has side effects too, mainly photosensitivity which of course when you are out and about in the tropics is a problem.

The main thing is to use a good mosquito repellant, wear long pants and long sleeves (light colors) and avoid being out when the bugs are most active.

[goji]

Cambodian residents will not take these drugs. Expats permanently living there will not take these drugs.
Malaria is treatable, the risk of infection is lower than for Dengue Fever.
Because of the Dengue Fever risk, you should be taking steps to repel mosquitoes in any case.
I also understand the Malaria risk in PP & Siem Reap is negligible.

I took medication on my first trip to Cambodia, did not do so on the second trip and will not to on the third trip either. I'll be doing exactly the same as the expats living in Cambodia.

[pong]

I think this is slightly incorrect above:
1.there are 3 best known varieties of anti-mal med.
malarone is the best-and strongest, and not known for many side-effects-but there is never ever a 100% garantee. In Asia (and certainly here in Thaild) it is NOT sold/available and kept at special clinics for treatment of serious cases if the other means fail. Also to prevent another case of not working after time.
the one that is so known for side-effects (though for a large part these seem to mean bad dreams-and especially for people who seem to have fobias of all kinds)-this is named Lariam. This does not mean it is ineffective-the best advice-if you decide to take it (other country) then to try out before you leave-and change if these symptoms hit you.
2.the most general advice for low-risk areas is not to take pills, but to take precautionous measures, like long sleeves, a plenty of DEET-cream, as soon as sun set abd inspect rooms and very carefully close all openings-and perhaps even a net around the bed.

[cottmann]

and you also have malaria strains that are resistant to the drugs. I tried Malarone a couple of times but the side effects were too much for me. Doxycycline is an antibiotic that is sometimes used to treat malaria...but it has side effects too, mainly photosensitivity which of course when you are out and about in the tropics is a problem.

The main thing is to use a good mosquito repellant, wear long pants and long sleeves (light colors) and avoid being out when the bugs are most active.

I agree with the mentioned preventative behavior. I used to take various preventative medications, and the suffered the noted side-effects. But I also suffered from a situation where my mucous membrances sloughed off in what I can only assume was a side-effect of the medication. My GP later told me it was a rare but not unknown side-effect of some medications. It was bad enough when the lining inside my mouth came away but when (not being circumcised) the top layer of skin on my cock and inside my foreskin sloughed off while I was taking the medication, I quickly stopped ingesting it. Long sleeves and mosquito repellant are infinitely preferable!

[Beachlover]

Totally agree... prevention of mosquito bites is the first thing.

From what I've heard, you are MORE likely to have side effects with Doxy. You are less likely to have side effects with Malarone but IF you DO have side effects from Malarone they can be more serious.