Did you take antimalarial drugs for Lembeh??

I am heading to Lembeh nest month and I am wondering about the need to take antimalarial drugs. The Lembeh Resort website states there are very few cases of malaria, but they recommend consulting with a doctor about antimalarial meds. I was just curious if those who have previously traveled to Lembeh have taken antimalarials.

Thanks, Doug

Hi Doug,

My limited research before going to Lembeh led me to the conclusion that antimalarial drugs were not necessary. We didn't take them and had no issues. Please note that I'm not a Doctor and have no medical training.

Cheers,

Steve

I also researched on lembeh and we determined it was highly unlikely. We didn't take any and ended up fine.

Dustin

I lived there for three years, never took them and never heard of anyone getting malaria. You should be fine

Kaj

I also lived there for 2 years, never took em, never an issue. I would be more concerned with Dengue Fever, but prevention is the same, long pants in the evenings and bug spray sort of thing.

North Sulawesi is a very low risk Malaria area, especially in the built up areas like Bitung.

Mike is pretty correct that dengue is a growing problem in Sulawesi (and pretty much the whole of South East Asia). However, unlike the crepuscular/nocturnal Anopheles mosquito, which is the mosquito that spreads Malaria, the Aedes mosquito, which spreads Dengue, is diurnal (daytime) and feeds mostly during daylight hours, which is why it's more difficult to control as people are most active during the day. Both genus are exo/endophagic, which means they bite indoor and out.

So the dengue issue is more a diurnal problem, which is probably why Mike got it since he's thinking its a nocturnal/crepuscular problem! Sorry Mike, couldn't resist!

We took a group to Indo (Lembeh/Wakatobi) and some people taking Malarone had bad psychological problems that cleared up as soon as they stopped taking the med. We've been in the area a couple of times and did not see any mosquitos or get bitten. My dos centavos, don't.

Side effects: http://www.drugs.com/sfx/malarone-side-effects.html

CDC: http://wwwnc.cdc.gov/travel/destinations/clinician/none/indonesia

Jlyle is correct to warn that starting any meds on a trip it's best to start at home to see if there are any adverse effects. You don't want to find out you are allergic to something and have serious adverse side effects in Indo.

I went there a couple years ago. Stayed at KBR and Warisaki (sp?). Before I went, I consulted with a doctor who specializes in travel issues. Although the malaria threat is low, it is not zero. He recommended that I take anti-malarials which I did. I did not notice any reaction. I can't remember for sure what I took, but Malarone sounds right.

When I went to Raja Ampat last year, I took a different anti-malarial as the malaria strains are different than Lembeh. Again, no reaction.

Also get a Typhoid shot and Hep A & B shots don't hurt either. As long as you're doing it add Tdap if not current.

PS> I am not a doc and don't play one on TV nor do I stay at Holiday Inn Express.

I agree that Dengue is a bigger problem than malaria, or so I'm told by those who should know.

We never took anti malarials and I agree that the risk of not doing so seems to be pretty low so even if it is not completely non existant.

However in addition to Dengue if you do get insect/fly bites and you are in the water a lot through diving then they can often become infected and can often require antibiotics to clear up. We spent a couple of months in N Sulawesi and all of us had at least one bite that got badly infected.

Cheers, Simon

Hi Doug,

My limited research before going to Lembeh led me to the conclusion that antimalarial drugs were not necessary. We didn't take them and had no issues. Please note that I'm not a Doctor and have no medical training.

 

Cheers,

Steve

Hi Doug,

My research before going to Lembeh led me to the conclusion that antimalarial drugs were necessary. I did take them and had no issues. Please note that I am a Doctor and have medical training.

And I'm taking antimalarials in Lembeh in October...

... one case of cerebral malaria is one too many for me!

Malarone is less likely to cause neuropsychiatric problems than Lariam (mefloquine is the big problem).

Cheers,

Tim

We never took anti malarials and I agree that the risk of not doing so seems to be pretty low so even if it is not completely non existant.

 

However in addition to Dengue if you do get insect/fly bites and you are in the water a lot through diving then they can often become infected and can often require antibiotics to clear up. We spent a couple of months in N Sulawesi and all of us had at least one bite that got badly infected.

 

Cheers, Simon

Ain't that the truth! I've had much more trouble with infected abrasions than any other diving health difficulty. I do carry antibiotics when travelling.

...some people taking Malarone had bad psychological problems...

 

...my dos centavos, don't.

 

Side effects: http://www.drugs.com/sfx/malarone-side-effects.html

 

CDC: http://wwwnc.cdc.gov/travel/destinations/clinician/none/indonesia

Have you looked at the CDC guidance?

"Areas with malaria: Rural areas of Kalimantan (Borneo), Nusa Tenggara Barat (includes the island of Lombok), Sulawesi, and Sumatra."

I would not be too worried as long as you stay on the coast/Island of Sulawesi.

If you would go for a longer treck in the Jungle I would consider to take Malarone.

You can also bring some Malarone as a backup in case you think that you got Malaria.

The daily dose is then higher, compared to if taken as a precaution.

/Erik

North Sulawesi is a very low risk Malaria area, especially in the built up areas like Bitung.

 

Mike is pretty correct that dengue is a growing problem in Sulawesi (and pretty much the whole of South East Asia). However, unlike the crepuscular/nocturnal Anopheles mosquito, which is the mosquito that spreads Malaria, the Aedes mosquito, which spreads Dengue, is diurnal (daytime) and feeds mostly during daylight hours, which is why it's more difficult to control as people are most active during the day. Both genus are exo/endophagic, which means they bite indoor and out.

So the dengue issue is more a diurnal problem, which is probably why Mike got it since he's thinking its a nocturnal/crepuscular problem! Sorry Mike, couldn't resist!

Funny Drew! However, remember I got Dengue in Sanur, Bali, not in Sulawesi. You are far far far more open to getting dengue in Bali rather than north Sulawesi. People seem to think that as Bali is such a tourist destination that its not as prevalent as more rural area, however, that would be 100% wrong...

I caught an eye infection in Lembeh. NEVER take your mask off underwater there. My eye closed up and then I started bumping into things (like hard beach umbrellas) and got an infected cut in my head. The first time I went, I forgot to take any antimalarials but my host said they never got malaria in N.Suluwesi - he got shipped out to Singapore wth Dengue Fever!

was staying in north Sulawesie for 6 years as dive instructor...working in Togian and banggai area...Malaria is present in North Sulawesie i did have several Malaria crisis . As i was staying permenently in the island, it was no way to take preventive medecine for years, so i was left with prevention : avoid mosquito bite...for guests staying short term, the chances are very mild ( especially with simple protections such as mosquito repelant at sunset time, and mosquito net at night ) ...Malaria can be very teritorial, it can be in one village a lot of cases and not much in the next vilage , so very difficult to predict ...

Mike is right : there is more chance to get Dengue ( what can be worse than Malaria ) in Bali or Jakarta than in remote area...

Been living in Thailand and Indonesia for 7 years, mostly Phuket & Bali. Never had malaria and have heard of very few cases even among people who travel a lot within these countries.

Dengue is a much more prevailing disease. Have had it twice. The second time was not pretty. Others around me have not had it. Unlucky or careless I must be...

I've been 22 years in Asia in Thailand, Indonesia and Palau and never had an issue with mosquitoes.

Prevention is the best way to deal with bites IMO.

I always take antimalarials when in that region. I often combine Lembeh with other areas of Indonesia/West Papua or PNG when I am there, so.....I know several people, including ex-pats who have contracted and continually struggle with Malaria from these regions and I am not about to risk it. I always take malarone, these days, and have never had an adverse reaction. I have had bad reactions from Larium.