Original post
L'actipal(antipaludéen) etant en vente à Madagascar peut-il etre utilisé en préventif?
Merci pour votre réponse
Antipaludéen "Actipal" à Madagascar
by Baboab
This discussion is in French, the community’s main language.
Bonsoir
NON...
Ce médicament est donné à titre gratuit, mais seulement lorsque le cas de palu est confirmé à partir d'un test de diagnostic rapide. Celui-ci est indispensable afin d'éviter le gaspillage vu le prix élevé de l'ACT. Les médecins sont habilités à administrer l'Actipal chez des sujets adultes selon la dose prescrite.
Composition: 3 cps d'artemisine et 3 cps d'amiodaquine. Ce qu'à l'OMS, on appelle un traitement combiné (ACT), toujours curatif (pour éviter les résistances!)
NON...
Ce médicament est donné à titre gratuit, mais seulement lorsque le cas de palu est confirmé à partir d'un test de diagnostic rapide. Celui-ci est indispensable afin d'éviter le gaspillage vu le prix élevé de l'ACT. Les médecins sont habilités à administrer l'Actipal chez des sujets adultes selon la dose prescrite.
Composition: 3 cps d'artemisine et 3 cps d'amiodaquine. Ce qu'à l'OMS, on appelle un traitement combiné (ACT), toujours curatif (pour éviter les résistances!)
Bonsoir
Les deux molécules actives de ce médicament sont l'artémisine (efficace en curatif mais très mauvais préventif) et l'amodiaquine qui est un bon curatif... et était un préventif à une certaine époque. Aujourd'hui il est fortement déconseillé en raison de ses effets secondaires, mais est toujours autorisé en curatif, le nombre de molécules dispo étant limité (et les effets secondaires étant liés à la prise prolongée).
Donc non, pour votre santé et sans même parler d'efficacité, il vaut mieux prendre un traitement préventif qu'essayer de prendre un curatif en longue durée.
Les deux molécules actives de ce médicament sont l'artémisine (efficace en curatif mais très mauvais préventif) et l'amodiaquine qui est un bon curatif... et était un préventif à une certaine époque. Aujourd'hui il est fortement déconseillé en raison de ses effets secondaires, mais est toujours autorisé en curatif, le nombre de molécules dispo étant limité (et les effets secondaires étant liés à la prise prolongée).
Donc non, pour votre santé et sans même parler d'efficacité, il vaut mieux prendre un traitement préventif qu'essayer de prendre un curatif en longue durée.
Merci pour vos réponses
Je pars régulierement à Mada 2x2mois (que depuis deux ans)et me protége autant que je peux des moustiques ma question etait pour mes enfants qui viennent nous rendre visite 15 jours
Je leur procurerai:malarone ou paludoxine
Comme vous semblaient bien etre au courant une petite derniére
Si malgrés mes précautions...j'ai une crise dois-je me traiter avec actipal ou malarone en curatif?
Pour la malarone en préventif attention au dosage si c'est pour des enfants.
Pour le curatif je vous conseille de changer de molécule (si la prévention est à la malarone autant changer en cas de crise) et j'aurais tendance à conseiller le coartem plutôt que l'actipal, il contient aussi un dérivé d'artémisine et de la luméfantrine qui est moins toxique que l'amodiaquine.
De plus il n'y a pas de contrindication pour les enfants à partir de 5kg alors que l'actipal est déconseillé chez l'enfant de moins de 6 ans (il me semble).
Pour le curatif je vous conseille de changer de molécule (si la prévention est à la malarone autant changer en cas de crise) et j'aurais tendance à conseiller le coartem plutôt que l'actipal, il contient aussi un dérivé d'artémisine et de la luméfantrine qui est moins toxique que l'amodiaquine.
De plus il n'y a pas de contrindication pour les enfants à partir de 5kg alors que l'actipal est déconseillé chez l'enfant de moins de 6 ans (il me semble).
Bonjour
Coartem est une association de deux molécules: 20 mg d'artéméther et 120 mg de luméfantrine...
bonjour platypus14
je te remercie pour ta réponse je pense de par ta réponse que tu es dans le milieu médical ou pharmaceutique .
je pars pour deux mois environ à Madagascar et je ne pas trop envie de prendre des médoc anti- palu pendant deux mois consécutif
je pense choisir plutôt de prendre le coartem en cas de crise!!!! si je suis piquer par une "vieille moustique purulente "hahahaha
si tu as des renseignements et des conseils a me donner sur la prise de ce médicament je suis preneur
cordialement
jean michel
Il est préférable, si vous n'êtes pas dans un endroit complètement isolé, de consulter un médecin (et de faire un test de diagnostic) avant de prendre le Coartem que vous pouvez tout à fait avoir dans vos bagages (vous serez sûr de sa qualité)
Si vous êtes dans un endroit loin de tout dispensaire (à plus de 8 heures), prenez le Coartem mais dirigez vous rapidement ensuite vers un centre médical.
Cette attitude, pour un séjour de deux mois, représente une prise de risque (elle est adaptée aux expatriés, faute de meilleure possibilité, vu les effets secondaires des médicaments préventifs en prise prolongée). Parlez en à votre médecin.
A ce propos, n'oubliez pas que la crise de paludisme peut se présenter de façon variable, la grande crise fièvre à 40°-frissons-sueurs certes, mais aussi très souvent un simple "embarras gastrique" ou une diarrhée associées à une fièvre. En zone tropicale (et au retour!) "toute fièvre est un paludisme jusqu'à preuve du contraire".
Cette attitude, pour un séjour de deux mois, représente une prise de risque (elle est adaptée aux expatriés, faute de meilleure possibilité, vu les effets secondaires des médicaments préventifs en prise prolongée). Parlez en à votre médecin.
A ce propos, n'oubliez pas que la crise de paludisme peut se présenter de façon variable, la grande crise fièvre à 40°-frissons-sueurs certes, mais aussi très souvent un simple "embarras gastrique" ou une diarrhée associées à une fièvre. En zone tropicale (et au retour!) "toute fièvre est un paludisme jusqu'à preuve du contraire".
bonjour platypus
j'ai bien noté vos renseignements et je suis un peu indécis maintenant sur la décision finale à prendre
je pense au travers de mon itinéraire que je serais certainement isolé et loin de dispensaire sur la cote est et st marie en remontant vers le nord par la cote .
pour vous le système de prévention serait le plus sérieux par exemple savarine sur deux mois?
que pensez vous du doxycycline comme moyen de prévention anti palu?
cordialement
jean michel
La Savarine est en général bien tolérée et puisque Madagascar est en zone 2 , il n'est pas utile de chercher à utiliser la doxy qui a plus d'effets secondaires et qui risque de faire apparaître des résistances.
Prenez éventuellement du Coartem en plus dans vos bagages en cas de problème..
Selon vos conditions de voyage, si vous allez en zone isolée, pensez à la vaccination contre la rage.
Mais le mieux est d'aller discuter de tout cela avec un médecin spécialisé en médecine des voyages (il y en a au moins un à Papeete...)
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