If you are travelling to Mozambique or the Kruger National Park this Easter weekend, read on: the National Institute for Communicable Diseases this week released an alert warning that malaria transmission is ongoing in SA and its neighbouring countries.
The number of malaria cases is expected to rise as a result of travel during the Easter holidays and the recent widespread rainfall and humidity across Southern Africa.
Dr Albie de Frey of Travel Doctor reports that there have been a number of malaria cases recently in areas where there had not been outbreaks for the last few decades, such as the Waterberg region.
All residents and travellers to and from malaria transmission areas (in South Africa this includes the north-eastern parts, covering Mopani and Vhembe districts of Limpopo Province, and the western parts of the Waterberg district (Thabazimbi and Lephalale areas) remain at risk. Other areas of high transmission risk include the lowveld of Mpumalanga Province, including the Kruger National Park and surrounds, and the northern KwaZulu-Natal Province-Mozambique border.
To help you keep safe, follow these simple tips
Preventing bites by the malaria-carrying Anopheles mosquito is ‘always indicated, irrespective of the use of tablet to avoid malaria’, says De Frey. Don’t go outdoors between dusk and dawn in risk areas, cover up (long pants and sleeves, socks and closed shoes), and apply insect repellent to all exposed areas.
There is still no vaccine available (one may be in the pipeline, but not for travellers), and no malaria prophylactic tablet is 100% effective in preventing malaria or totally free of side effects. However, it is still crucial to take one of those available – they offer 90% protection, says De Frey, and malaria is a serious disease that kills rapidly.
The main choice today is between mefloquine (Lariam®/Mefliame®), taken once a week; doxycycline (which has many trade names), taken once a day after meals; and a combination of atovaquone and proguanil (Malanil®/Mozitec®/Malateq®), also taken once a day. Mefloquine and doxycycline must be taken for four weeks after leaving the malaria area, atovaquone/proguanil can be stopped after seven days but is much more expensive, says De Frey.
He adds that they all have the same minor side effects – ‘much less serious than malaria’ – and the final choice depends on personal preference ‘and the traveller’s chronic disease and medication profile’. Your medical professional or a travel doctor can prescribe the one best suited to you.
Know the signs of malaria, and that they can manifest even if you have taken all precautions. ‘Seek early help!’ says De Frey. Also be aware that signs may show only weeks, months, and even years after you have been bitten. They are cold shivers, high fever, sweating, headache, nausea, vomiting and diarrhea, muscle pain, weakness and finally bleeding, convulsions and coma (‘cerebral malaria’).
Many of these signs can be misdiagnosed as flu with fatal results, so if you have been to a malaria-risk area at any stage, tell your health practitioner and insist on being tested.
‘If you are close to good medical care you should be tested by a laboratory,’ says De Frey. ‘If you are going to travel remotely, you may want to take a malaria rapid test kit along, but then you and your travel companions must get trained on when and how to use it – and phone for knowledgeable medical assistance when you do use the kit.’ (Your Clicks pharmacy can order kits on request, says Clicks pharmacist Waheed Abdurahman.)
A single negative malaria test never excludes malaria, De Frey says – ‘repeat the test within hours if the person is no better or gets worse’.
If you are diagnosed with malaria, it needs to be treated as a medical emergency. Early treatment is key – the anti-malarial drug artemether-lumefantrine (Coartem®) is highly effective for uncomplicated malaria provided treatment is started quickly.
Pregnant women and babies may be treated instead with oral quinine plus either doxycycline or clindamycin. ‘The Travel Doctor advises that pregnant women and children under 5 should best avoid high risk malaria areas altogether,’ says De Frey. Follow your doctor’s advice.
(All medicines mentioned above must be prescribed by a doctor after a consultation and cannot be bought without prescription, says Abdurahman.)
IMAGE CREDIT: Getty Image