This page is a guide line only and all travellers are strongly recommended to visit either their private doctor or a health clinic, experienced in travel, 4-8 weeks before departure for further medical advice.
Malaria
WHAT IS MALARIA?
Malaria is a potentially fatal illness of tropical and subtropical regions. The disease is caused by a parasite which is transmitted to humans bitten by infected mosquitoes. The disease is widespread in Africa, and over one million people die of malaria every year on the continent, mostly children under the age of five.
WHICH AREAS HARBOUR MALARIA?
Within South Africa’s borders the disease is encountered mainly in Northern & Eastern Mpumalanga, Northern KwaZulu Natal and the border areas of Northern and North West provinces.
Considering South Africa’s neighbours, malaria is also considered to be a threat to travellers visiting the lower lying areas such as Swaziland, while it is encountered throughout Mozambique and Zimbabwe, much of Botswana. Northern Namibia is also a malaria area.
Within South Africa’s boarders, malaria transmission is at its highest during warmer and wetter months of November through to April. For May through to October, the risks of acquiring malaria are reduced, but low risk does not mean that there is no risk!
HOW TO AVOID MALARIA
Prevention of malaria relies upon adopting personal protection measures designed to reduce the chances of attracting a mosquito bite, and the use of appropriate malaria medication. Both personal protection methods and anti-malarial medications are important, and neither should be neglected at the expense of the other.
PERSONAL PROTECTION MEASURES
Personal protection measures against mosquito-bites include:
If possible, avoid being outdoors at night, when malaria carrying mosquitoes are likely to bite.
Wearing light coloured clothing to conceal as much of the body as practical, especially from dusk until dawn
Sleeping under mosquito nets
The use of appropriate insect repellent containing di-ethyl toluamide (also know as DEET)
The spraying of sleeping quarters at night with a pyrethoid containing insecticide
The burning of an insecticide coils or the use of electronic vaporizing mats
ANTI-MALARIA TABLETS (PROPHYLAXIS)
There are a number of different types of anti-malaria tablets available. Choosing one depends upon the particular area being visited and the traveller’s medical history.
Within South Africa’s borders, SAA-Netcare Travel Clinics recommend either mefloquine, doxycycline, or atovaquone-proguanil as being the most effective anti-malaria tablets. All of these drugs require a prescription.
Mefloquine
Mefloquine is taken once a week. This should be commenced at least one week before entering the malaria, weekly while in the malaria area and continued for four weeks after leaving the malaria area. Mefloquine is best taken after a meal and with liquids. Mefloquine is not suited for persons with epilepsy, certain heart problems and depression.
Doxycycline
Doxycycline is taken once a day, starting a day before entering a malaria area, daily while in the malaria are and for four weeks after leaving the malaria area. The drug should be taken after a meal, and washed down with plenty of liquid. It should be avoided in pregnancy and children under the age of 8.
Atovaquone-proguanil
Atovaquone-proguanil is taken once a day, starting one to two days before entering a malaria area, daily while in the malaria area and for seven days after leaving the malaria area.
No method of malaria prevention is one hundred per cent effective, and there is a small chance of contracting malaria despite the taking of anti-malaria medication and the adoption of personal protection methods.
This does not mean that malaria medication and personal protection measures should be neglected, as they greatly reduce your risk of getting malaria.
Any traveller developing possible symptoms of malaria should seek medical advice despite having taken the prescribed precautions.
WHY IS MALARIA DANGEROUS?
Most of the malaria found within South Africa is caused by Plasmodium falciparum. It is potentially the most dangerous type of malaria, and can prove rapidly fatal.
Symptoms may develop as soon as seven days after entering a malaria area and as long as six months after leaving a malaria area. Symptoms of malaria can be mild in the initial stages, resembling influenza.
MALARIA SYMPTOMS
Symptoms of malaria may include:
Generalized body of ache
Tiredness
Headaches
Sore throat
Diarrhoea
Fever
It is worth emphasizing that these symptoms may not be dramatic, and can easily be mistaken for an attack of influenza or similar life threatening illness. Deterioration can be sudden and dramatic.
A high swing in fever may develop, with marked shivering and dramatic perspiration. Complications of a serious nature, such as involvement of the kidneys or brain (cerebral malaria) may then follow.
Cerebral malaria is extremely serious, with the victim becoming delirious and entering a coma. Cerebral malaria is frequently fatal, and it is extremely important that all suspected cases of malaria should receive immediate medical attention.
All persons possibly exposed to malaria developing influenza-like illnesses or fever within seven days after entering a malaria area should seek immediate medical attention!
Urgent blood tests must be taken to check for possible malaria infection. It may be sensible to have a second blood test taken if a first test is negative for malaria, to be certain of excluding the disease.
DIVING AND MALARIA
Scuba diving is a sport that requires orientation and concentration. The compressed nitrogen that divers breathe can have an effect on the brain and can cause nitrogen narcosis in severe cases.
It is believed that the anti-malarial drug Mefloquine may interact adversely with compressed nitrogen leading to an increased risk of confusion and disorientation.
Divers are therefore advised to avoid using mefloquine when diving. Alternative anti-malarial drugs are available which do not have the risks that mefloquine have.
Divers are advised to consult experts in travel medicine before departure, to establish which anti-malarial would be best for them personally.
MALARIA SUMMARY
Malaria is a potentially fatal disease transmitted by mosquitoes.
Prevention relies on measure to reduce bites, and taking anti-malaria medication appropriately both for the destination and the traveller.
All travellers developing influenza symptoms or fever after visiting a malaria area should be tested for malaria, even if they took preventive measures.
A splendid beach location and a delightful infinity pool, combined with spacious shady palm gardens, make this a prime destination.
The food is good but not special and the wait between choice and service and between courses is lengthy (this is common in Mozambique). Helpful and friendly staff contribute to a comfortable stay; although, some would benefit from further training. Prices are a little high for this level of accommodation. The steps down from the car-park (which has a fishing pool - the children loved it) are tricky for the old or infirm.
