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malaria nord botswana en juillet ?

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jacquesp
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Bonjour
Je dois me rendre au nord du Botswana ( Okavongo, Moremi, Chaubet) en juillet. Un traitement préventif anti palludéen est il nécessaire en cette période (froide et sèche) ?
Merci

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jculos
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Le ven 16 mai 2008 à 18:03

Quote:

posté à l'origine par jacquesp
Bonjour
Je dois me rendre au nord du Botswana ( Okavongo, Moremi, Chaubet) en juillet. Un traitement préventif anti palludéen est il nécessaire en cette période (froide et sèche) ?
Merci

Le nord du pays est la zone la plus impaludée et la plus humide. Il me semble risqué de ne pas prendre de traitement anti palu

Le dim 18 mai 2008 à 17:22

Malaria in Botswana:

Prophylaxis is recommended for all travel to the northern part of the country (north of 22 degrees south in the provinces of Central, Chobe, Ghanzi, and Ngamiland), including safaris to the Okavango Delta area. No risk in the city of Gaborone. Transmission occurs mainly from November to June. Either mefloquine (Lariam), atovaquone/proguanil (Malarone)(PDF), or doxycycline may be given. Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting, dizziness, insomnia, and nightmares. Rarely, severe reactions occur, including depression, anxiety, psychosis, hallucinations, and seizures. Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine.

Those taking mefloquine (Lariam) should read the Lariam Medication Guide (PDF). Atovaquone/proguanil (Malarone) is a recently approved combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure. Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare. Doxycycline is effective, but may cause an exaggerated sunburn reaction, which limits its usefulness in the tropics.

Long-term travelers who may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours. See malaria for details. Symptoms of malaria sometimes do not occur for months or even years after exposure.

Insect protection measures are essential.

For further information about malaria in Botswana, including a map showing the risk in different parts of the country, go to the World Health Organization and Southern Africa Malaria Control.

Le dim 18 mai 2008 à 17:28

Summary of recommendations:

All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure.

Malaria: Prophylaxis with Lariam, Malarone, or doxycycline is recommended for the northern part of the country (north of 22 degrees south in the provinces of Central, Chobe, Ghanzi, and Ngamiland), including safaris to the Okavango Delta area. No risk in the city of Gaborone.

De plus:

Vaccinations:
Hepatitis A Recommended for all travelers
Typhoid Recommended for all travelers
Yellow fever Required for all travelers arriving from a yellow-fever-infected area in Africa or the Americas.
Polio One-time booster recommended for any adult traveler who completed the childhood series but never had polio vaccine as an adult
Hepatitis B For travelers who may have intimate contact with local residents, especially if visiting for more than 6 months
Rabies For travelers who may have direct contact with animals and may not have access to medical care
Measles, mumps, rubella (MMR) Two doses recommended for all travelers born after 1956, if not previously given
Tetanus-diphtheria Revaccination recommended every 10 years

Medications

Travelers' diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions, as outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. A quinolone antibiotic is usually prescribed: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) (PDF) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.

Most cases of travelers' diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.
If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

Though effective, antibiotics are not recommended prophylactically (i.e. to prevent diarrhea before it occurs) because of the risk of adverse effects, though this approach may be warranted in special situations, such as immunocompromised travelers.