Anti-malaria prophylaxis for Southern Africa trip (9)
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Dear Leela,
My kids were 3 and 5 years old when we came to Malawi. I usually
"buried" the tablet in a spoon-full of yoghurt. However the tablet
dissolve quickly in such an environment and the ensuing mixture then
becomes indeed very unpalatable. Therefore intake should follow
preparation within seconds, which means the kids have to be prepared to
take it. As to availability of Yoghurt, you can even prepare it from
milk powder yourself. We never had problems with the kids not wanting
the tablets, in fact the younger boy was initially furies that he did
not get "as much" as Sarah. We had a policy of discussing the
potentials of our environment, in Europe it's on traffic lights - in
Malawi it was on Mosquito's, and they took care that we did not forget
the tablet during breakfast.
As you argue you might encounter any mosquito bites at all, in which
case you just don't take the daily tablet dosage. Again this is in my
view a strong reason for using a Proguanil/Folic acid prophylaxis, it
can be taken on a day by day or p.n. basis. And the basis for your
daily decision is based on your very personal judgement of your past 24
hours exposure. I like this approach because it makes my customers
realise, observe and evaluate the Malariogenic environment consciously
and does not "depersonalise" the Malaria issue the way the Lariam
approach does. However, a slightly higher customer IQ is needed for my
approach and it is therefore not universally applicable, I agree.
Frank
--
Frank Paulin
mailto:hma18@keele.ac.uk
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