Ask general practitioner Maarten: Yellow fever vaccination and malaria pills for the elderly
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
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Dear Martin,
I am a man of 81 years, height 1.81 m, weight 80 kg, blood pressure 120/75. Not a smoker and moderate drinker. I have had Diabetes Mellitus II for 30 years for which I am on the following medications:
- Diaprel MR 60 2x daily
- Eucreas 50 mg/1000 mg twice a day
- Sortis 40 mg 1x daily
In addition to my diabetes, I have also had heart fibrillation for years, which does not bother me at all, but I do have to use a blood thinner every day, namely Wafarin 3 mg and Tritace 5 mg once a day.
Due to all the restrictions and requirements imposed by the Thai government, it does not look like I will be able to spend my annual hibernation period of 8 months with my girlfriend in Thailand for the time being. Now I have decided to go to friends who have a 2nd home in Gambia in a few months. I have a few medical questions about that.
The Gambia is a high-risk country with regard to Yellow Fever and Malaria. Vaccination for Yellow fever is mandatory and for Malaria it is recommended to take malaria pills daily. Now I heard that vaccination against Yellow fever is not wise for people over 65 years old. I also hear conflicting reports about malaria pills.
Please advice also regarding my current medication and combinations, although at my 3 monthly check-ups for my diabetes, all blood/urine values are in order.
Regards,
R.
*****
Dear R,
Indeed, yellow fever vaccination in the elderly is more risky. See here: https://nathnacyfzone.org.uk/factsheet/20/individuals-aged-60-years-and-older The risk is around 2,2 per 100.000. With you, because of diabetes probably a little higher.
As far as malaria is concerned, the risk is not great and you will have to weigh up which is more risky. The side effects of the pills, or the risk of malaria.
People know this best in The Gambia and I would therefore follow the advice from that country.
As for the other medicines, take enough with you, or inquire about what is available there and don't worry if you forget the Sortis.
Also find out whether your coagulation (warfarin) can be measured.
Yours faithfully,
Dr. Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).