Malaria

What is malaria?

Malaria is a mosquito-borne disease caused by any one of five malaria parasite species i.e Plasmodium falciparum, ovale, vivax, malariae and knowlesi. The disease is transmitted to people by the female Anopheles vector mosquito. This disease is a leading cause of debilitating illness, with over 200 million cases each year from around the world. 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.

Who gets malaria?

Any person residing in or traveling to a country where malaria is prevalent is at risk for contracting the disease. Malaria is currently a problem in tropical or subtropical areas of Asia, Africa and Central and South America. Most black Africans show a natural resistance to some species of malaria. Otherwise, susceptibility to malaria is universal.

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 is malaria spread?

Malaria is spread by the bite of an infected Anopheles mosquito. With certain malaria species, dormant forms can be produced which may cause relapses of malaria months to years later. Malaria may also be transmitted by transfusion of blood from infected people or by the use of contaminated needles or syringes.

What are the symptoms of malaria?

Symptoms of malaria may include:

  • Fever
  • Chills
  • Sweats
  • Generalized body of ache
  • Tiredness
  • Headaches
  • Diarrhoea
  • Cycles of chills, fever and sweating occurring every one, two or three days is a good indicator of malaria in a person recently returning from a tropical area.

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.

How soon do symptoms occur?

The time between the infective mosquito bite and the development of malaria symptoms can range from 12 to 30 days depending on the type of Plasmodia involved. When infection occurs by blood transfusion, the incubation period depends on the number of parasites transferred but is usually less than two months.

When and for how long is a person able to spread malaria?

Untreated or inadequately treated cases may be a source of mosquito infection for one to three years depending on the strain of Plasmodium. Direct person-to-person transmission does not occur. Stored blood products can remain infective for 16 days.

What is the treatment for malaria?

Malaria can be detected by using microscope and Rapid Diagnostic Test kit (RDT). Malaria can be very dangerous and even fatal if it is not treated. Early treatment reduces the chances of complications. See your doctor right away if you think you may have malaria. Make sure you inform your doctor of any recent travel and any medications you took while travelling.

  • 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.

    Prophylactic medicine must be taken at least 24 hours before entering a malaria endemic area then for the duration of stay in the area and for 4 weeks after leaving the area. No method of malaria prevention is 100% 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.

Due to the changing pattern of drug-resistant strains, current recommendations can be obtained from your local, county or state health department.

What can be done to prevent the spread of malaria?

Exposure to citizens occurs most frequently during foreign travel to malarious areas. It is very important to contact health officials to determine the proper preventive drug therapy. Personal protection measures against mosquito-bites include:

  • If possible, avoid being outdoors at night, when malaria carrying mosquitoes are likely to bite.
  • Wearing long sleeved clothing to conceal as much of the body as possible, especially from dusk until dawn.
  • The liberal and frequent use of mosquito repellents.
  • 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.

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.

Courtesy : CDC , Compliled by: Miss P Govender (STA-CDC)

 

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This page last edited on 17 January, 2019

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