South Africa is the only country in Africa that can officially offer a fully malaria-free safari experience. The assured malaria-free safari areas are the Eastern Cape, North West Province (including the Pilanesberg National Park and the Madikwe Game Reserve), and the Waterberg.
Malaria is caused by a one-celled parasite called a Plasmodium. Female Anopheles mosquitoes pick up the parasite from infected people when they bite to obtain blood needed to nurture their eggs. Inside the mosquito the parasites reproduce and develop.
Malaria parasite – Plasmodium is a genus of unicellular eukaryotes that are obligate parasites of vertebrates and insects. Malaria is a life-threatening mosquito-borne blood disease caused by a Plasmodium parasite. The parasites travel to the liver where they mature and reproduce. Malaria has been recognized since the Greek and Roman civilizations over 2,000 years ago. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches.
The malaria parasite is not in an infected person’s saliva and it is not passed on from one person to another. The only way you can catch malaria from a person is through blood transfusions or organ transplants.
For most people, symptoms begin 10 days to 4 weeks after infection, although a person may feel ill as early as 7 days or as late as 1 year later. Two kinds of malaria, P. vivax and P. ovale, can occur again (relapsing malaria). If the right drugs are used, people who have malaria can be cured and all the malaria parasites can be cleared from their body. In general, it takes about two weeks of treatment to be cured of malaria. People travelling to areas where malaria is common typically take protective drugs before, during and after their trip. Treatment includes antimalarial drugs. Malaria is often also incorrectly diagnosed as flu.
Without proper treatment, malaria episodes (fever, chills, sweating) can return periodically over a period of years. After repeated exposure, patients will become partially immune and develop milder disease. Treatment of malaria depends on the number of different factors that include disease severity, the particular species of Plasmodium infecting the patient and the potential for drug resistance of the various species and strains of Plasmodium. In general, it takes about two weeks of treatment to be cured of malaria.
Malaria is a life-threatening disease. It’s typically transmitted through the bite of an infected Anopheles mosquito. Infected mosquitoes carry the Plasmodium parasite. When this mosquito bites you, the parasite is released into your bloodstream.
The most common antimalarial drugs include:
- Chloroquine (Aralen)
- Quinine sulfate (Qualaquin)
- Hydroxychloroquine (Plaquenil)
- Combination of atovaquone and proguanil (Malarone)
Call your doctor at once if you have a serious side effect such as:
- severe or uncontrolled vomiting or diarrhea;
- fever, mouth sores;
- problems with speech, balance, or walking;
- severe skin rash;
- nausea, stomach pain, loss of appetite, dark urine
Choosing the Anti-Malarial Medication That’s Right for You:
- Atovaquone/proguanil. Brand Names: Malarone, Malanil.
- Chloroquine. Brand Names: Aralen, Resochin and Dawaquin.
- Doxycycline. Brand Names: Vibramycin, Monodox, Periostat, Vibra-Tabs.
- Mefloquine. Brand Names: Lariam, Mephaquin, Mefliam.
- Primaquine. Brand Names: Primaquine.
Make sure you take the right antimalarial tablets at the right dose, and finish the course. If you are sick within one hour of taking your daily tablet, you need to take another dose to make sure you remain protected against malaria. Some drugs are not effective because the parasite is resistant to them.
Medicines to prevent malaria that you take daily include doxycycline and atovone/proguanil (Malarone). All prophylactic drugs should be taken with unfailing regularity for the duration of the stay in the malaria risk area, and should be continued for 4 weeks after the last possible exposure to infection, since parasites may still emerge from the liver during this period.
Diagnosis of malaria involves performing blood smears. For a blood smear, a drop of blood is applied to and spread onto a glass slide. It is then treated with a special stain and examined under a microscope for the morphology of infected blood cells and the parasite.
In early stages only red blood cells get affected. Later, Malaria mostly affects liver and spleen causing hepato and spleenomegaly.
Anemia is common in patients with malaria, in part due to the effects of the Plasmodium parasite on the red cells. It is extremely uncommon for malaria to cause skin lesions or rash.
In the vast majority of cases, malaria is only transmitted via the bite of an infected mosquito. However, if a pregnant woman becomes infected with malaria, she can pass the parasite to her unborn child via the placenta, or via blood transfer during childbirth.
Bite prevention – avoid mosquito bites by using insect repellent, covering your arms and legs, and using a mosquito net. All travelers should be advised that personal protection from mosquito bites between dusk and dawn is their first line of defense against malaria. Check whether you need to take malaria prevention tablets – if you do, make sure you take the right antimalarial tablets at the right dose, and finish the course.
General Health Risks: Malaria
Malaria is transmitted by the night-time – dusk to dawn – biting female Anopheles mosquito.
Risk is absent in most of the country; risk exists only in specified areas:
Note: Travellers visiting Kruger National Park and Tembe National Park are advised to take malaria suppressive medication during the peak risk period. Take meticulous anti-mosquito measures from dusk to dawn year round.
High risk months for Malaria are: January to December
Malaria transmission vector(s): A.funestus, A.gambiae
Incidence of Plasmodium falciparum Malaria: 90%
Of the five species of human malaria parasites, Plasmodium falciparum is the most dangerous. The remaining percentage represents malaria infections that may be caused by one or more of the following parasites: Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi.
Areas with drug resistant Malaria: Multidrug resistant P. falciparum malaria is present in all malarious areas of South Africa. The antimalarial medications listed below are effective for this country.
Suppressive Medication Guide
All malaria infections are serious illnesses and must be treated as a medical emergency. In offering guidance on the choice of antimalarial drugs, the main concern is to provide protection against Plasmodium falciparum malaria, the most dangerous and often fatal form of the illness.
Regardless of the medication which has been taken, it is of utmost importance for travellers and their physician to consider fever and flu-like symptoms appearing 7 days up to several months after leaving a malarious area as a malaria breakthrough. Early diagnosis is essential for successful treatment.
In addition to the suggested antimalarial medication, use a mosquito bed net and effective repellents to avoid the bite of the nocturnal Anopheles mosquito.
VIA: https://www.iamat.org/country/south-africa/risk/malaria International Association for Medical Assistance to Travellers. IAMAT
South Africa is one of 14 African countries to have received recognition for its fight against malaria during the 2016 African Leaders Malaria Alliance (Alma) meeting on 30 January as part of the 26th African Union Summit in Ethiopia.
South Africa’s progress
In South Africa, cases of malaria have decreased by 82%; and the malaria related death rate has dropped by 71% since the year 2000 to date.
The decrease is attributed to a sound malaria vector control programme, in which the country has used dichlorodiphenyltrichloroethane or DDT odourless insecticide for indoor residual spraying, coupled with other World Health Organization recommended interventions.