Comment by sametmax | Hacker News Reader

Comment by sametmax | Hacker News Reader

Important reminder:

- The atovaquone/proguanil (e.g: Malarone) combo still works well. It's affordable and widely available.

- It's also __curative__, meaning it DOES destroy the plasmodium in the liver (not just in the blood). The fact we are using it preventively often leads people to think we still can't cure malaria. If you have malaria, go see a tropical disease specialist to get rid of those nasty recurring episodes.

- Any anti malaria drugs have very serious side effects, even if Malarone is the nicest of all. If you end up living in a infected country for good, you should really ponder how long it's acceptable to take it. In the end, both the parasite and Malarone will attack your liver. Yeah, it sucks.

That being said, it's always good to have new options, if just to reduce the chance of resistance. Chloroquine based drugs (e.g: Nivaquine) are pretty much useless now because of it, and I don't know anybody who tried Mefloquine (e.g: Lariam) that will ever go back to it.

I've had Lariam once or twice as Malarone used to be really expensive in the UK (10$ vs 150$ ish) and I don't think I had any of the famous side effects. It can be hard to tell when you're in a radically different country, very hot, with strange food and drinking a lot...

I took Larium (Mefloquine) for about 7 months while in the US Peace Corps. I had incredibly vivid dreams, all of which I would remember and I also developed depression that went away as soon as I switched off the drug. No good.

I ended up working for a company in another country that didn't have any requirements regarding malaria prophylaxis so I didn't take any drugs. I got malaria and it was god awful for a couple days but got over it quickly. Compared to the side effects of Larium or taking heavy doses of Doxycycline or getting the more spendy Malarone, it was worth rolling the dice.

Do not drink at all while taking Lariam, at least in my experience. I would never take that crap again. I woke up on the side of a road where the police had dropped me off right outside town after some moderate drinking, and I am a heavy "partier."

Not only that but it brought out weird parts of my personality that aren't normally more than background chatter I ignore in my daily life, like grandiosity and melodramatic emotionality including severe melancholy.

Last time I took Larium was near the White Nile in Uganda for 3 weeks. The beer there is pretty strong and people stay up late! During the trip I did feel pretty lethargic, but it was very hot and I was very active so I didn't blame the larium. No other symptoms. On other trips I've taken Chloroquinine/Proaganol (this is what it's called in the UK anyway) and it was fine, I think that is only useful in a few regions now though?

The new drug is designed to kill plasmodium vivax which is relatevely rare in Africa. IMHO Malarone is not effective against this "softer" form of malaria which would usually not kill you if untreated.

Plasmodium falciparum is responsible for the most dangerous form of malaria and is common in large parts of sub-saharan Africa. Like OP stated correctly, it is (still) curable, but the new drug discussed in the article is probably not an option here.

By the way the plasmodium vivax kind of malaria was still present in northern Germany (and probably parts of the Netherlands) in the 20th century, with Anopheles atroparvus being the vector. It's unclear why it disappeared in the 1960s but sleeping away from cattle and proper water management is always a good idea.

I've been living in malarial regions for 2 years now. I stopped taking my daily malarone pills after 6 months. Now I only take it when I've been bit quite heavily or if I start to feel sick.

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