I don't take prophylactic malaria drugs.
It is a matter of plus and minus, and the points on the minus list are too many.
Malaria in Dar es Salaam is not that frequent, though there was an increase in the numbers after the long rain season in April.
Mosquitos love water and warm blooded people. And the risk of malaria should always be dealt with.
But either prophylactics are too expensive, too rough for your body (especially if you take them for years - and the health risks compared to the risk of actually getting it shouldn't be underestimated), or they simply don't work 100% (which adds on another factor of instability as you might not be 100% aware that you have malaria).
What I do, is that I ALWAYS travel out of Dar es Salaam with a box of Malarone and arthenam (for treatment), a thermometre (something I learnt from already having suffered from severe malaria is that you loose the feeling of what's going on, and the thermometre is a good guideline), painkillers (to lower the fever), and lastly I travel with a self test kit (in the case that there are no clinics, or as in many hospitals in smaller towns in Europe - simply no test options.)
The latter is actually more critical than most people imagine. The Europeans are not used to malaria, though the areas with wetlands in parts of Europe actually suffered from malaria in my parent's generation. But if you go to a small town hospital in Denmark chances are that the staff doesn't know exactly what to do. Going to the national hospital in Copenhagen chances are that they overreact and want to test you for anything you can take out of Africa.
I tried it, and I didn't like it. Malaria is the absolute worst I have experienced, and the only time ever in my life where I thought, for seconds, that that was that. So, obviously, I don't promote not to do prophylactics or to do self medication, but to think twice, to be aware, always to do proper technical prophylactics (dress properly, sleep under bed nets, repellent spray etc.).
The only place in Dar es Salaam you can buy this malaria self test kit is in the very well assorted chemist in Oysterbay Shopping Mall. 5 test kits for 17,500 TSH is surely worth it.
Read more here - but do not leave for Africa unprepared - do always also consult a doctor or a vaccination clinic before you leave. Or even better ask how other expats, in the place you are going to, go about malaria. (I still hold my right to question the Danish doctors on this issue - one doctor once prescribed me Malarone for three years when I told him I was going to Northern Uganda, and told me straight how stupid I was if I didn't follow his advice. Malarone had only at that time been tested, officially, on rats - and the price of it would swallow my entire sum of resettlement allowance.)
