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Old 3rd Apr 2009, 21:41
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soggyboxers
 
Join Date: Sep 2001
Location: In the Haven of Peace
Age: 79
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rwm,

Actually cerebral malaria is not a separate form of malaria; it is a complication of falciparum malaria whose signs are normally manifested as impaired neurological functions and possible loss of consciousness. It has a mortality rate of around 20% in adults receiving treatment and almost 100% for those who receive no treatment. It was usually treated with quinine, but nowadays is often treated with Artemether or Artesunate.

Larium (mefloquine hydrochloride) may cause hallucinations, but not doxycycline. Larium is forbidden as a chemoprophylaxis for pilots by most aviation companies because of this and if you're flying in an oil related industry, most major oil companies requiring a chemoprophylaxis programme specify Malarone or Doxycycline in West African countries such as Cameroon and Nigeria. Artemisinin-based combination therapy (ACT) seems to be the the choice for most effective treatment these days. The WHO currently recommends the following ACTs in Africa:
artemether-lumefantrine, artesunate + amodiaquine;
artesunate + sulfadoxine-pyrimethamine.

Partial treatments should not be given even when patients are
considered to be semi-immune or the diagnosis is uncertain. A
full course of effective treatment should always be given once a decision to give antimalarial treatment has been reached.

When travelling out on leave I always carry an ACT pack with me and I have a home-made card in my wallet stating that I live and work in a malarial area in West Africa where Falciparum malaria is prevalent and in case of collapse I should be treated for malaria.

A short fact sheet from the WHO can be found at:

WHO Malaria Fact Sheet

or if you want the full 266 page Malaria treatment guide:

WHO Malarial Treatment Guide
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