Malaria Paper

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Malaria

Malaria is a potentially fatal illness of tropical and subtropical regions. The disease is
caused by a parasite which is transmitted to human beings bitten by infected mosquitoes.
The disease is widespread in Africa, and over one million people die of malaria every year
on the continent.

WHICH AREAS HARBOUR MALARIA? Within South Africa's borders the disease is encountered
mainly in northern and eastern Mpumalanga, northern Kwa-Zulu Natal, and the border areas
of the 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 of
Swaziland, while it is encountered throughout Mozambique and Zimbabwe, and much of
Botswana. Northern Namibia is also a malarious area. Within South Africa's borders,
malaria transmission is at its highest during the warmer and wetter months of November
through to April. From May through to October the risks of acquiring malaria are reduced.
For a full size map and a list of game parks follow this link.(368K) 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 anti-malarial
medication. Both personal protection methods and anti-malarial medication are important,
and neither should be neglected at the expense of the other.

PERSONAL PROTECTION MEASURES Personal protection measures against mosquito bites include
the use of an appropriate insect repellent containing di-ethyl toluamide (also known as
DEET), the wearing clothing to conceal as much of the body as practical, sleeping under
mosquito nets, and the spraying of sleeping quarters at night with a suitable pyrethroid
containing insecticide, or the burning of an insecticide laden coil. If at all possible
avoid being outdoors at night, when malaria carrying mosquitoes are more likely to bite.

ANTI-MALARIA TABLETS (PROPHYLAXIS) There are a number of different types of anti-malaria
tablets available. The exact choice of which to use depends both upon the particular area
being visited, and the traveller's own medical history. Within South Africa's borders
either a combination of chloroquine with proguanil, or Mefloquine (Mefliam) alone are the
commonly used anti-malaria tablets. Chloroquine and proguanil are available without a
doctor's prescription. Mefloquine (Mefliam) can only be obtained with a doctor's
prescription. Because of the emergence of chloroquine resistant strains of malaria in
South Africa, chloroquine should not be taken alone but should always be combined with
proguanil. The adult dosage is two chloroquine tablets per week, starting one week before
entering the malarious area. Proguanil may be started twenty-four hours before entering
the malarious area, and two tablets must be taken every day. Both chloroquine and
proguanil should be taken for four weeks after departing the malarious area, and both are
best taken at night after a meal.

Mefloquine (Mefliam) is taken in adult dosage of one tablet per week. This should be
commenced at least one week before entering the malarious area and continued for four
weeks after leaving the malarious area. Like chloroquine and proguanil, Mefloquine
(Mefliam) is best taken at night after a meal, and with liquids. The principal
contra-indications to the use of Mefloquine (Mefliam) are a history of treatment for
psychiatric disorder or epilepsy. No method of malaria prevention is one hundred per cent
effective, and there is still 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 anti-malaria medication and personal protection measures should be neglected,
simply that 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 Southern Africa is of the
falciparum species. This is potentially the most dangerous species of malaria, and can
prove rapidly fatal. Symptoms may develop as soon as seven days after arrival in a
malarious area, or as long as three months after leaving a malarious area. Symptoms of
malaria are often beguilingly mild in the initial stages, resembling influenza.

MALARIA SYMPTOMS Symptoms of malaria may include a generalised body ache, tiredness,
headache, sore throat, diarrhoea, and fever. It is worth emphasising that these symptoms
may not be dramatic, and can easily be mistaken for an attack of influenza or similar
non-life threatening illness. Deterioration can then be sudden and dramatic, with a rapid
increase in the number of parasites in the victim's blood stream. A high swinging fever
may develop, with marked shivering and dramatic perspiration.

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