Since the start of January, I have had incredibly vivid dreams. I can’t remember the last time I slept through the night soundly, and it’s beginning to get unpleasant. At first I thought it was stress-related, because I’ve been significantly more stressed and busy this term than I have in a long time. But my sleep patterns have been so consistently poor that I’m beginning to think that stress is not the only underlying reason.

Let’s rewind a bit. From June 2007 to June 2008, I was on Mefloquine, an anti-malaria drug taken weekly. I wasn’t in areas with malaria that whole time, but the Mefloquine prescription starts one week before you’re in a malaria zone and lasts for four weeks after. I traveled so much during that year that I was on Mefloquine continuously.

Mefloquine is notorious for giving people vivid dreams. Add that to the list of other side effects, and it’s a pretty scary drug. (“Mefloquine may have severe and permanent adverse side effects.” Fantastic.) To top it off, apparently it’s not uncommon for people who have taken Mefloquine in the past to continue experiencing side effects long after they’ve stopped taking it (does almost 3 years count?), especially during period of high stress.

Mefloquine is probably one of the worst malaria prophylaxes, but it’s one of the more common because it’s cheap and weekly (as opposed to expensive and daily). Other options such as Malarone have a better reputation, but they’re all still rather powerful drugs.

So in June 2008, I stopped taking malaria prophylaxis altogether. Here’s why:

1. Malaria prophylaxes are powerful, and I don’t want them in my body. Especially for long period of time. I don’t like taking regular pain killers, and the thought of putting something significantly more powerful in my body scares me. Also, would you want to take a drug that gives you side effects years after you’ve stopped taking it?

2. Malaria prophylaxes don’t always work. Certain prophylaxis only protect against certain strains of malaria, and there’s no guarantee that’s the one you’re going to get. I have a friend who spent a few months in Africa on two separate occasions, took prophylaxis both times, and got malaria, both times.

3. Malaria tests and treatments are easy to come by and more trustworthy in Africa. If there’s one test that every clinic has the ability to do, it’s a malaria test. Ok, there are probably some rural and poorly stocked clinics that are currently out of the supplies, but in general this is one of the most common diseases that clinics deal with. Both the test and the treatment are also cheaper in Africa (there’s a higher demand for them), and frankly I trust them more. Western doctors probably see very few malaria patients, and so no matter how much experience they have in medicine, they are less likely to be as familiar with malaria.

So I sleep under a mosquito net, I get myself tested if I feel sick, and I carry a treatment (just in case I’m somewhere without access to a treatment). Now I just need to get rid of the side effects from my year on Mefloquine back in ’07 – ’08.

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