Our research indicated that in broad terms the malarial risk area starts near the top of Argentina in the Departments of Oran and San Martin in Salta Province and continues north all the way to Guatamala in Central America. However it is not a case of clearly defined boundaries as the level of risk varies from ‘very low or nil’ through to ‘high’ throughout the region and of course mosquitos don’t observe lines drawn on maps. For instance in Mexico there is a low risk in parts of Chiapas and a very low risk in other areas such as Chihuahua, Durango, Nayarit, Quintana Roo and Sinaloa. In Bolivia there is a high risk across the north and east of the country where it borders Brazil, a high or variable risk along the border with Paraguay and a low to no risk in the western part of the country. If you know exactly which parts of each country you will visit you could be very targeted with your medication but if you want to visit all areas then you’ll probably want to medicate for the high risk areas.
For our trip we have to add in two other factors. Firstly we’re not entirely sure how long we will spend in the risk areas and secondly some of the anti-malarial medications have side effects we personally want to avoid. Jenny for instance suffers from migraines and headaches and Jim has to ‘pilot’ the bike so needs to be mentally alert (that’ll be a first)! Some of the drugs have side effects that wouldn’t be very helpful in those respects. For any motorcycle traveller it may well be that the space they have available to carry medication is also an important consideration. The number of tablets you carry depends not only on the period of time you’ll spend in the malaria risk areas but also on the dosage which varies dependent on the drug taken – some are taken daily (lots of tablets needed), some are weekly tablets.
Jenny did a lot of research into anti-malarials and there are a surprising number of factors to be taken into account and quite a few different medications available. However, if you do your research and seek professional advice you won’t go far wrong (here in the UK a travel clinic will help, speak to your GP). One decision you’ll need to make before you leave is whether to buy your anti-malarials in your home country or out there on the road. The travel forums have a number of discussions on this subject with some contributors advocating purchase whilst on the road and others saying ‘no way’. We’ve purchased all we’ll need for the entire trip here in the UK and as you’ll see in the photo’s below a bit of careful ‘repacking’ drastically reduces the volume of stuff you carry because like most medications, anti-malarials are more ‘fresh air and box’ than actual tablets.
By the way, just to make life more complicated, some areas are drug resistant to one of the old ‘mainstays’ of anti-malarial drugs – Chloroquine (large parts of Brazil, parts of Bolivia, Peru, Columbia, Venezeula, Guyana and Suriname – basically the Amazon Basin area and the peripheries of the countries bordering it).
For our trip we had to approximate how long we will be in the malaria zones of South America and Central America in order to work out how many tablets to get and we had to determine what ‘regimens’ were advised for each area. Some drugs require you take them before and/or after you’ve been in the risk area aswell. So for South America we have opted for Doxycycline and for Central America, Proguanil. Doxycycline requires 1 tablet daily and Proguanil is 2 tablets daily. We could have carried less tablets if we went for something like Mefloquine which is 1 tablet weekly however the side effects precluded it for us (mental disturbances!) So seek professional advice from your GP and practice prevention (cover up with long sleeves, use sprays with DEET in etc).
We found a lot of useful information on Malaria on the following websites: