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#2101: Health safeguards in Haiti : Judson comments
From:Drjudson@aol.com
Here is another thought on the Lariam issue addressed by Anne Russell.
While at Hospital Albert Schweitzer in Central Haiti for the past two years,
we did participate in a WHO study. Hospitals all over Haiti including ours
checked blood smears of patients known to have Malaria after treatment with
Chloroquin. there were no failures of treatment. CHLOROQUIN IS COMPLETELY
ADEQUATE FOR VISITS TO HAITI. Its other name is Aralen. Dose is 50mgs taken
once a week beginning one week before departure and finishing three weeks
after return to the States. Prophylaxsis is extremely important. One of our
visitors who was only there for four days did not do so and, upon return
home, spent a week in the Intensive Care Unit with Cerebral Malaria! If
Chloroquin is problem for anyone, the other proven effective routine is to
take Doxycycline 100mgs per day beginning three days before departure and
finishing two weeks after return. This routine can be problem for some
because it might make them more sensitive to the sun. Finally, Mefloquine
(Lariam) should NOT be used in Haiti for all of the reasons outlined by Anne
Russell but also because it has one terrible side effect which is not common
but terrifying. This is toxic psychosis which required on weeks psychiatric
hospitalization for at least one person who took that drug before coming to
our hospital. His family was badly frightened by this event but there was no
problem afterwards. Lariam is necessary in some parts of the world but not
in Haiti! Hope this is helpful - let me know if questions.
John P. Judson, MD