Malaria – prevention is the first line of defence
With Malaria being in the news recently with fatal cases of suspected “Suitcase Malaria” in North West Province, a summary of facts and methods of prevention of this deadly disease might be useful.
Malaria is a parasitic disease that is transmitted by the female Anopheles mosquito. Malaria is potentially deadly but it is a curable disease and early detection and treatment limit complications.
In South Africa the following species of Malaria parasites and their prevalence are as follow: Plasmodium falciparum 90%, Plasmodium vivax 5% and Plasmodium ovale 5%
Consider the ABCD of Malaria prevention, it might be a life saver:
Awareness of risk
The first step in preventing Malaria will be to find out if an area you will be travelling to will pose a risk in this regard.
In South Africa the high risk areas include: the Lowveld of Mpumalanga and Limpopo. This includes the Kruger National Park.
The far North of KwaZulu Natal bordering Mozambique (Maputoland Coast)
Intermediate risk areas include: Kosi Bay, Sodwana, Mkuze Game Reserve and St. Lucia Lake.
Low risk areas include North West Province, Northern Cape, Kgalagadi Transfrontier Park.
The highest prevalence of Malaria is during the warmer Summer months, from September to the end of May.
Cases of Malaria in low risk areas can occur mainly due to suitcase Malaria which refers to infection through an infected mosquito which was translocated (via trucks, other modes of transport, in suitcases) and infects someone at it’s destination.
Bite prevention
Precautions should be taken especially between dawn and dusk, when female mosquito’s are most active.
- Remain indoors.
- Wear long-sleeved clothing, trousers and socks.
- Apply insect repellent to exposed skin – Tabard, Peaceful sleep etc. Re apply every 4-6 hours.
- Close windows and doors at night unless they are screened.
- Spray insecticides inside sleeping areas.
- Burn mosquito coils, mosquito mats, or use electrical devices releasing insect repellents.
- Use bed nets that are mosquito proof.
Chemoprophylaxis
Oral prophylaxis include: Atovaquone-proguanil , Doxycycline, Mefloquine/Larium, Malarone/Malanil
Discuss these with your health care professional as factors like area effectiveness, side effects and contra-indications of some medical conditions might influence your choice.
It is important that these drugs be taken according to the package insert. Generally one would start taking them before travels, during- and also for a period after traveling. Compliance in this regard is important.
Diagnosis
Patients that traveled to malaria areas and present flu-like symptoms should consult with a doctor as soon as possible. It is very important to inform your doctor that you have been to an area posing a malaria risk and request to be tested.
Flu-like symptoms of Malaria include: headache, fever, muscle and joint pain, sweating, shivering attacks, nausea, diarrhea, fatigue, coughing.
Testing involves a blood test to evaluate blood parameters, blood smears are checked for parasites and antigen testing.
It is ideal that all patients that traveled to a malaria area should be tested irrespective of the time of year and whether they took chemoprophylaxis or not.
Keep in mind that all precautionary steps only lower the risk, the risk still exists! When in doubt rather consult your medical professional to get tested. Rather be safe than sorry.
Travel Clinics in Rustenburg:
Mooney Close Travel Clinic: 014 533 1168
Magalies View Travel Clinic: 014 592 8968