Lost in the Mail: Should I Skip Expensive Malaria Meds?

Central and South America, Health & Safety, Lost in the Mail — By on September 28, 2009 at 6:00 am

We’re long overdue to answer a question from the reader e-mailbag-and we thought this one from LG Alexandra was a particularly relevant one, given how expensive it is to take proper precautions against malaria. When you’re trying to save every penny on the road, should you cut corners, skip the pills and risk getting sick? We brought in an MD to answer this one…

Q. I’m planning a big adventure-quitting my job and heading to Guatemala for Spanish language school and volunteer work, then heading south through Central and Southern America and seeing where I end up. I actually was wondering what you guys did about malaria medication during your own trip? It’s a bit difficult-not to mention expensive-to take malaria for an extended period of time, especially because I’m going to parts of South America that are resistant to certain types of meds. I’ve been hearing about people not taking medication, being extra vigilant, and just treating the diseases if they unfortunately get it. Others just buy medication from a pharmacy in the country. I was just wondering what plan of attack you ladies took?


A. We asked Phyllis Kozarsky, M.D. and a Travel Health Expert at the CDC for a little advice on this one. She explained that many travelers are confused as to whether they should use “stand-by” medication for the treatment of malaria rather than paying for and using the more expensive preventative medication.

“For most who travel to malarious areas, it is highly recommended that they take prophylaxis (preventative meds) to ward off the disease,” she says. “People are worried about the long-term effects of the drugs, but even missionaries and volunteers who remain in malarious areas for several years at a time often take the medications throughout their entire stay–and the drugs are well tolerated by the body.”
While the meds may seem expensive (they could potentially set you back hundred of dollars depending upon the length of our trip) should you contract malaria, the cost will be far greater to your health and to your wallet. “The price of hospitalization, transportation to a good health care facility, plus the time spent out from work, etc, is higher than that of the pills themselves-and people often forget this,” says Kozarsky. “And don’t forget, malaria is an illness that can kill. There are several deaths due to malaria among American travelers every year.”
Whether you need malaria medication or not is a question that should be posed to your doctor or travel medicine specialist. He or she can tell you if you’re actually visiting an affected region or not (Guatamala City, for example, does not require medication, but there’s disease in rural areas of the country).
The strains of malaria also differ from region to region, so it’s important to take the right form of medication to combat particularly resistant varieties. There are several different types of meds, including chloroquine, doxycycline and Malarone, but each comes with its own set of side effects and can vary widely in cost. According to Kozarsky, Malarone like has fewer side effects, but is more expensive.
Since many American insurance plans don’t cover the cost of travel shots and prescriptions, some travelers just wait until they get to where they’re going to take advantage of lower in-country pricing. Kozarsky advises against taking that action. “The market for counterfeit medications is huge and growing, she says. “Most of these counterfeit medications are available in developing countries, look the same as ‘real’ medications and even have identical packaging.” That means, even if you’re taking pills, you could still get sick.
Since the medical needs and destinations visited will vary from person to person, there’s no easy answer to the questions posed by our reader above. To get the best traveler-specific advice from a medical professional, Kozarsky recomends visiting a travel medicine clinic. You can find the names and contact info for qualified docs online at the International Society of Travel Medicine (www.istm.org). And remember, when in doubt, don’t scrimp-just take the pills.
Got a burning travel question that you need answered? Email us at lostgirlsworld@gmail.com
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  • La Limada. says:

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    I just started a kind of travel-advice blog, more geared toward the long-term traveler.
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    I have like no readers right now but I wrote a little post about you guys!

  • MissGadabout says:

    hey i've had this problem as well and it depends when you will be in the malaria ridden areas. i say to just take it – taking a pill is alot less painful than getting malaria – especially in those areas that the pills is highly recommended. check out the cdc website. also be mindful as the doc says of the different kinds of malaria pills for different regions, e.g. for panama and belize you take two different pills but only if you are really going trekking. id recommend isla tigre by the way – if you are into off the beaten track. regarding the pill again, it is kinda annoying when you have to take 5 weeks worth of pills (just once a week though) for just being a couple of days in a malaria region, but better safe than sorry. i think its about $50 each with certain insurances its 4 per month for free though.

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