I read your piece on Lariam (WDDTY vol 14 no 5) and thought I'd report some experiences my family had over Christmas in Kenya with Malarone [atovaquone/proguanil hydrochloride].
All of us have either lived in that country or visited it many times. Usually, I take nothing for malaria but, this time, I decided - against my intuition - to get hold of some antimalarial pills before travelling. A Western doctor who has lived in East Africa for 20 years advised me to treat with extreme scepticism what I am told in the West about malaria and antimalarial treatments. His advice for Kenya is to take Paludrine [systemic proguanil] daily, and supplement it with weekly chloroquine. This combination is, in his family's experience, very safe, very cheap and with remarkably few side-effects. My GP/nurse refused to prescribe either of these, and insisted on giving me a prescription for Malarone - at a cost of lb10 per head.
Unfortunately, I cannot comment on the antimalarial properties of Malarone as we were all forced to stop taking it after a week - during which three of us suffered diarrhoea and two got mouth ulcers. My elder son couldn't work out whether he was hungry or not (he loves food), and my baby son became extremely aggressive and refused all efforts to feed him.
I would be most interested to hear of others' experiences of this drug, good or bad. - Martin Armitage-Smith, via e-mail
WDDTY replies: Several studies have demonstrated the fast-acting and apparently non-toxic properties of the Chinese herb Artemisia annua (wormwood) as an antimalarial drug (WDDTY vol 8 no 2). It is available from BioCare and is a general antiparasitic (tel: 0121 433 3727). Another alternative is the extract of cinchona bark, the natural source of quinine.