Malaria in South Africa: Introduction and Advice

Disclaimer: this post is not meant to replace medical advice from a medical doctor. If you’re planning a trip to Africa, please consult with your medical doctor on malaria and other diseases.

Malaria Risk Map

The first thing to know about malaria in South Africa is that it’s prevalant only in the country’s three northeasternmost provinces – KwaZulu Natal, Mpumalanga and Limpopo – and only in their outermost regions. See the map (provided by malaria.org.za) for SA malaria risk areas.

You do not need to take precautions against malaria for trips to SA that are limited to Cape Town, Durban, Johannesburg, or any of the country’s six malaria-free provinces: North West, Northern Cape, Western Cape, Eastern Cape, Free State, Gauteng.

(Note that parts of the North West and Northern Cape provinces, in certain areas along the borders with Botswana and Namibia – including the Kalahari desert – sometimes require seasonal malaria precautions. Check in advance with your local contact.)

You do need to take precautions if you plan to enter a malaria-prevalant zone, including the Kruger National Park, during any part of your trip here.

• Risk of malaria infection in prevalent areas is highest between October and May.
• Kruger National Park malaria information hotline: +27 (0) 82 234 1800.

The second thing to know is that malaria is both preventable and curable. You can prevent a malaria infection through sensible behavior and orally-taken drugs; and you can cure it with a combination of medicines.

Preventing malaria:
No single preventative measure is 100% effective, so it’s essential to adopt a few (very simple) strategies at once.

• Prevent mosquito bites. Clearly your first line of defence! Mosquitos are most active at dawn and dusk; these are the times to put on long-sleeved clothing, and to wear insect repellent. Tabard is the most popular insect-repellent in South Africa – it comes in stick, lotion and aerosol form. Spray repellent directly on to your clothing, and make sure to attend to your ankles, hands, neck, face and hair. Use repellent every four hours.
• Take an oral prophylactic. Here are the top choices, all of which are available in South Africa (and often less expensive than in the US/Europe):
  • Malarone is the first choice, being the drug which the malaria parasite (southern Africa strains) is the least resistant to, and having the least recorded side effects. It’s called Malanil in South Africa; both brands are manufactured by Glaxo Smith Kline. Begin the course 2-3 days before entering a malaria area, and end it seven days after leaving the area.
  • Doxycycline is an antibiotic proven to be effective against malaria. The length of the regimen can have adverse effects on the digestive tract, however, which can be alleviated to some degree with probiotics like Inteflora.
  • Mefloquin, better known by its brand name, Larium, remains a popular anti-malaria prophylactic, and is the least expensive of the drugs. It’s physical and psychological side-effects, however, are fairly notorious, and some reports state that certain southern African malaria strains have become resistant to it.

Curing malaria:
If you become infected with malaria, the cure will depend on the circumstances of the infection. An infection usually becomes apparent within 7 days, but may not manifest for up to three months.

• Know the symptoms. It’s important to catch the infection as early as possible. Chills, pains, headaches, fever – flu-like symptoms – can all be signs of malaria.
• Get to a doctor. The sooner a diagnosis, the quicker the cure. In the Kruger National Park, the nearest doctor is at the park’s Skukuza camp: +27 (0) 13 735 5638.

More malaria info:
Centers for Disease Control
Malaria.org.za
Roll Back Malaria – WHO
Google News