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Malaria
General
- There are four important species of Malaria, Malaria tropica (parasite :
Plasmodium falsiparum), Malaria ovale, Malaria vivax (tertianae) and
Malaria quartana.
In the coastal region of Westafrica the Malaria tropica is mostly present. The female
mosquitos (anopheles) suck the blood from an infected person, that contains
the gametocytes (parasites).
Those develop sexually in the intestine of the anopheles to sporozoites,
which can pass through the wall of intestine into the gland of saliva of the mosquito.
At the next blood meal of the anopheles on a human, the blood grinning will be suppressed
by the saliva and at the same time the malaria brought in the blood circulation by
the incoming sporozoites.
Prophylaxis
- To make your stay here in Benin mostly comfortable, we recommend
a prophylaxis with Nivaquine® (100mg/day Chloroquin)
and Paludrine® (1 tablet twice per week). The prophylaxis should
begin at the first day and be continued for 30 days after the return.
- It has also to be made clear, that no absolute prevention exists.
There is always a possibility to catch a malaria even taking the tablets regularly.
The incubation time is 7 to 12 days.
If you have some malaria symptoms after the return of a journey
(Fever, Headache, Diarrhoea, pain in the joints), go immediatly
for a visit to a doctor for tropical diseases or directly to a Tropical Institute.
The non-specialised doctors often do not realise the symptoms.
- Protect yourself well against the bites of the female
Anopheles-mosquito from dusk by wearing clothes with long
arms and a good repellent, like
ExoPic8®, a Liposomale Lotion from Spirig (CH-4622 Egerkingen,
Schweiz) or Autan®.
- Always sleep under a mosquito net, they are installed almost
everywhere, but may also be bought in Bénin.
- Citronel Lotion, is a locally produced, a well-perfumed essence of
citronella grass acts which also as a very well repellent. Citronel Tea in huge
quantities helps also to protect preventive against mosquito bites.
Therapy
- In case you get infected, there is a good therapy with
the medicament Coartem® of
Novartis
(in CH sold under the label Riamet®),
which can be found in Cotonou in each pharmacy (ca. 3'000 FCFA for 8 tablets,
5000 FCFA for 16 tablets).
In case of trips in the inner part of the country, you should it take with you for
prevention.
Be warned, the boxes in CH contain 24 tablets, here in Cotonou boxes
for children (8 tablets) and such with 16 tablets are sold. Even the employees in the
pharmacies often do not realise the difference.
- In the following table the dosage prescription of the attached notice
is presented in a readable overview.
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Coartem/Riamet
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Number of tablets
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Initial dosage
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after
8 h*)
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after
24 h*)
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after
48 h*)
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total
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Under the control of a medical doctor :
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Children 05 - 14 kg
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1
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1
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1
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1
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4
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Children 15 - 24 kg
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2
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2
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2
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2
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8
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Children 25 - 34 kg
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3
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3
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3
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3
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12
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Adults
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4
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4
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4
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4
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16
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In cases of multiresistence and for auto medication
(if there is no medical
doctor available) :
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Initial dosage
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after *)
8 h
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after *)
12 + 24 h
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after *)
36 + 48 h
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total
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Children 10 - 14 kg
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1
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1
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1 + 1
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1 + 1
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6
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Children 15 - 24 kg
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2
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2
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2 + 2
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2 + 2
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12
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Children 25 - 34 kg
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3
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3
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3 + 3
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3 + 3
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18
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Adults
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4
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4
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4 + 4
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4 + 4
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24
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*) Counted as number of hours after having taken the initial dosage.
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- Before starting a therapy, a test should be made (if possible)
or at least go and talk to a local doctor.
- Since a certain time
Malarone®,
is on the market. We have heard from peoples about good experiences
with this medicine. Unfortunately this medicine is also often prescribed
for prevention. Thus, the resistance of the parasites against this medicine
may rise with time.
We therefore recommend Malarone for therapy only.
- If you are taking some other medicine, inform yourself seriously
about the side effects at a Tropical Institute concerning the prevention or therapy
of malaria.
- Strong medicine like Lariam® from
Roche or Halfan® (ca. 5'000 FCFA) from
SmthKlineBeecham should only be taken as a therapy and not for prevention,
there have already some malaria resistances been seen.
You can find some information about Mefloquin (Lariam®), diabetes and
blood thinners (04.06.02) under
Gesundes Reisen des BNI
Recently the journals (Spiegel) reported some information about different
side effects (deep depressions etc.) when using Lariam.
Inform yourself about this medicine before taking the tablets.
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Other recommendations
- The Water service is very good in all greater urban areas of the country.
Mineral water is sold everywhere but also the usual drinking city-water
is in general well prepared.
- Fruits : Don't be concerned about fruits during your holidays! Never miss
the wonderful taste of mangos, pineapples, chap-chap
(corossol - variety of the annone) and naturally also the bananas, oranges und mandarines.
- Vegetables and salads may be eaten without concern in the great
restaurants. The salad is usually cleaned by Potassium permanganate before being served.
- Ice-cream, Glace is sold here by Potassium on bikes.
It's usually Fanmilk, and comes from a factory in Togo. It is packed in small plastic
bags. Beyond the fact that, most of the time it's not frozen but only creamy, we didn't hear
anything negative about it.
The ice-cream in Jardin Helvetia is always freshly made,
using fresh fruits and may be tasted without any harm.
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Tropenmedizin@Utanet.at
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