The document provides recommendations for a travel medicine kit for travel to the Ethiopian highlands, including vaccinations, malaria prophylaxis, and other drugs. It recommends vaccinations for hepatitis A, typhoid fever, meningococcus, and yellow fever. It notes the meningitis belt of sub-Saharan Africa and areas at risk for yellow fever. For malaria prevention, it recommends malaria prophylaxis drugs based on altitude. The kit should include antibiotics, antidiarrheals, pain relievers, skin and eye ointments, bandages, and hand sanitizers. Potatoes and Coke are also suggested for minor ailments.

1. TRAVEL MEDICINE KIT FOR
ETHIOPIA HIGHLANDS
Dr. Dino Sgarabotto
Malattie Infettive e Tropicali
Azienda Ospedaliera di Padova

2. Vaccinations
• Against Hepatitis A (Havrix): 1° shot covers you for the
travel while 2° shot (after 1-2 months) covers you for life
• Against Typhoid fever (lasts only 3 years). Two choices
available:
– Oral vaccine (Vivotif): 1 tab on alternative days for 3 days,
fasting (far from food; antibiotics and antimalarial forbibben
for 1 week) and can be given in children older than 3 months
– Im. vaccine (Typhym Vi): 1 shot only but can be given in
children older than 5 years
• Against Meningoccus: sub-type A is the most common in
the meningitis belt and so Mencevax ACWY should be
used: 1 im. shot lasts 3 years
• Against Yellow fever: Stamaril 1 im shot only lasts 10
years
• Check you coverage against Tetanus and Hepatitis B

3. The meningitis belt
The meningitis belt of sub-Saharan Africa,
stretching from Senegal in the west to
Ethiopia in the east, has the highest rates of
the disease.

4. Areas at Risk of Yellow Fever Transmission

5. Yellow fever is a compulsory
vaccination to and fro these countries
• Angola, Benin, Burkina Faso,
Burundi, Camerun, Congo, Ivory
Coast, Gabon, Ghana, Guinea
Bissau, Liberia, Mali, Niger,
Central African Republic,
Democratic Republic of Congo, Ruanda,
Sao Tomè e Principe, Sierra Leone, Togo

6. Malaria prophylaxis
• Malaria is endemic below 2000 m above sea
• Addis Ababa is 2400 m above sea
• After the rainy season malaria can be found
along rivers and lakes up to 2100 m above sea
• Lariam 250 mg 1 tab a week (continue 1 month
after coming back) or Malarone 250/100 mg 1
tab a day (continue 1 week after coming back)

7. Malaria: high risk map

8. Drugs for a group of 4-5 people
• Doxycycline 100 mg 20 tabs
• Azithromycin 500 mg 6 tabs
• Ciprofloxacin 500 mg 24 tabs
• Paracetamol 500 mg 32 tabs
• Ibuprofen 400 mg 24 tabs
• Loperamide 2 mg 24 tabs (if you are using the
rapidly dissolving tablets, dry your hands before
opening the blister pack to carefully remove a
tablet. Place the tablet on the tongue, allow it to
dissolve completely, then swallow it with saliva)
• Domperidone 10 mg 30 tabs (as above)

9. Other drugs for a group of 4-5 people
• Tetracycline skin ointment 3 tubes
• Hydrocortisone 1% skin ointment 2 tubes
• Tetracycline eye ointment 3 tubes
• Chlorhexidine 1% solution as skin disinfectant 1
small bottle
• Band-Aid type adhesive bandages 2 boxes
• Sterile gauzes for dressing 2 boxes
• Elastic bandages for dressing 2 boxes
• Alcohol based hand sanitazers for each person

10. Useful resourses
• Potatoes: to be grated for preparing a cream
to apply on red eyes
• Coke: drink in small amounts (table spoon)
every 5 min when oral rehydratation solution
not available

11. Different minor settings
• Tonsillitis, otitis and upper respiratory tract
infection: azitromycin OD or doxycycline BD
for 6 days
• Cystitis or traveller’s diarrhoea: ciprofloxacin
BD for 3-5 days
• traveller’s diarrhoea: add 4-5 tabs of
loperamide a day (1 tab every 4-6 hours)
• repeated vomiting: use domperidone 1 tab
every 8 hours for 1 day

12. THANK YOU!
free download from www.slideshare.net