HEALTH MATTERS
The following are some suggestions to help you plan ahead, but you should consult the CDC website, at cdc.gov/travel/destinationghana for the most current information. You may need to go to a travel clinic for some of these immunizations and for their advice, but consult your own physician too. When making inquiries, be sure to specify that you are going to southern Ghana, not the north, which is environmentally very different, and be sure to specify that you=ll be there in July and August.
Yellow fever: This is required for entrance into Ghana. It is only given at special authorized yellow fever clinics, and is good for 10 years.
Typhoid: Happily, this is in pill form! You take it in several dosages, so it=s a good one to begin early.
Hepatitis A & B: Hepatitis A is a good one to have, but you probably do not need Hepatitis B, depending on your own personal social plans.
Malaria: You must take an anti-malarial drug, as malaria is endemic to West Africa. People get malaria even with medication, but the case is usually less serious. Even Africans, even those with sickle-cell, get malaria. Malaria seldom kills adult Africans because those who will die of it have done so in childhood, and some resistance builds up during adulthood. But it can kill adults, and even non-lethal cases can send you to bed with high fever for a weekBnot worth the risk on a three-week trip. The malaria rate in cities is actually very low, and we=ll generally be in rural areas only during the day, when the mosquitos are inactive, but again, it is not a risk worth taking. Here are some recommended prophylaxes:
The #1 choice is Malarone (proguanil), recommended by the CDC and what most of our travelers have been taking. It does cause some of the same side effects as Larium, but at a much lower rate. You need to take this every day, but you don=t need to begin it as soon or continue it as long afterwards as with most other medications. If you have ever had problems with seizures, depression, or serious anxiety, you may want to consider Doxycylcine instead.
#2 choice is Doxycycline. This is slightly less effective than Malarone, but healthier for someone taking it for a long time (years). One problem is that, like any antibiotic, it can cause sensitivity to sun; that is less of a problem for us because it will be cloudy much of the time and you can keep covered with a light shirt and a sunhat. The other problem, also common to antibiotics, is that it can make you vulnerable to yeast infections, so you may want to bring along something for that.
Not a choice: Beware of Mefloquine, which is also known as Lariam, and don=t confuse the name with Malarone! The negative side effects of this can include Adizziness, difficulty sleeping, anxiety, vivid dreams, and visual disturbances, . . . and occasionally, though rarely, seizures, depression, and psychosis. . . . [The] side effects caused by mefloquine may persist weeks to months after the drug has been stopped@ (CDC website, 2007). If you consider taking Lariam, please read the 2002 Consumer Report article on it first, and make sure your physician has all the latest information of side effects.
Not a choice: Chloroquine is useful in some areas, such as Mexico, the Caribbean, and the Middle East, and Eastern Europe, but is not effective in West Africa.