Malaria In Africa

Malaria in Africa is the most important disease hazard facing hunters. Malaria is widespread throughout most of Africa and is a serious and sometimes fatal disease.

Malaria Map
Dark Green = Malaria Transmission areas, Light Green = Areas where malaria has been largely eliminated, Yellow = Malaria free

For individual country maps go to: Malaria in African Hunting Countries

Malaria Facts

  • Malaria is a parasitic disease spread by the bites of female Anopheles mosquitoes.
  • Anopheles mosquitoes can be recognised by their 'head down' resting posture. Other types of mosquitoes hold their heads up in line with the body.
  • The malaria parasite is called Plasmodium.
  • 4 species of Plasmodium cause malaria in humans - Plasmodium Falciparum, Plasmodium Vivax, Plasmodium Ovale, Plasmodium Malariae.
  • The parasites are in the mosquito saliva which is injected into the person to prevent the blood coagulating.
  • The severity of the malaria disease is related to the number of parasites in the person's blood.
  • Falciparum malaria is the most serious causing severe or even fatal consequences.

Malaria Symptoms

  • The incubation period from the time of the bite to symptoms appearing is 5 to 10 days but may be up to even a year if anti-malarial drugs were taken.
  • Principal symptoms are fever, chills with sweating, headache, abdominal pain and jaundice.
  • Severe falciparum malaria causes symptoms associated with liver and kidney failure, anaemia, convulsions and coma.

Malaria Diagnosis

  • As the early symptoms of malaria are pretty non-specific, be aware of the possibility of having malaria for at least a year after you return home from a malarial area.
  • If you get any fevers or other vague symptoms, seek medical attention and a malaria test as soon as possible.

Malaria Testing Kits

  • If you are going to be hunting or travelling in a very remote malarial area of Africa consider taking some malaria testing kits.
  • They are small and simple to use. All the requirements (lance, reagent, sterile swab and indicator) are sealed in a sterile pouch. A pin prick of blood is mixed with a reagent and placed on an indicator strip rather like pregnancy testing. The result can be read after a few minutes.
  • They can be purchased at most travel clinics or pharmacist shops.

Malaria Treatment

  • Again, if you are going to a remote malarial area, discuss with your travel medicine expert or physician the merits of taking malarial treatment drugs.
  • Coartem tablets (Artemeter and lumefantrine) can be used to treat uncomplicated falciparum and vivax malaria.
  • Coartem is an intensive 3 day course of tablets with dosage dependent on body weight. Read the instructions carefully.
  • Take a few boxes of Coartem in case you need to help others.

Malaria Prevention

You cannot be vaccinated against malaria in Africa or elsewhere, but you can protect yourself in 3 ways:

  • Avoiding mosquito bites
  • Taking anti-malarial drugs
  • Getting prompt treatment if you suspect you or someone with you may have malaria

Avoiding Mosquito Bites

  • Mosquitoes bite at any time of day but most bites occur in the evening.
  • If you are out in the evening or night, wear long-sleeved clothing and long trousers.
  • Mosquitoes may bite through thin clothing, so spray an insecticide or repellent on them. Insect repellents should also be used on exposed skin.
  • Spraying insecticides in the room, burning pyrethroid coils and heating insecticide impregnated tablets all help to control mosquitoes
  • If sleeping in an unscreened room, or out of doors, a mosquito net (which should be impregnated with insecticide) is a sensible precaution.
  • Garlic, Vitamin B and ultrasound devices do not prevent mosquito bites.

Taking Anti-Malarial Drugs

  • Start before travel as guided by your travel health advisor. Some anti-malarials need to be started three weeks before arriving in a malarial area.
  • Take the tablets absolutely regularly, preferably with or after a meal.
  • It is extremely important to continue to take them for four weeks after you have returned, to cover the incubation period of the disease. Malarone is require to be taken only 7 days post-travel.
  • Make sure you use a drug which you can tolerate and one which is appropriate for your destination(s).
  • No drug is 100% effective

Prompt Treatment

  • There is no guarantee of complete protection from malaria in Africa.
  • If you get a fever between one week after first exposure and up to one year after your return, you should seek medical attention and tell the doctor that you have been in a malaria area.

Common Anti-Malarial Drugs

Chloroquine

Brands: Avloclor, Nivaquine

  • Consider a trial course before departure if using this regime for the first time. This is recommended to detect if you are likely to get side effects.
  • Chloroquine should be started one week before exposure (to ensure adequate blood levels), throughout exposure and for 4 weeks afterwards.
  • Nausea and sometimes diarrhoea can occur which may be reduced by taking tablets after food.
  • Headache, rashes, skin itch, blurred distance vision (which may take up to 4 weeks to reverse) or hair loss may warrant changing to alternative drugs.
  • Use with caution with liver and renal disease.
  • Can aggravate psoriasis and very occasionally causes a convulsion so it should not normally be used in those with epilepsy.
Proguanil

Brand: Paludrine

  • One or two doses should be taken before departure. It should be continued throughout exposure and for 4 weeks afterwards.
  • Anorexia, nausea, diarrhoea and mouth ulcers can occur.
  • Can delay the metabolism of the anticoagulant, warfarin, and result in bleeding. Those planning to take warfarin must discuss this with their doctor before starting any treatment.
  • Use with caution with renal impairment.
Mefloquine

Brand: Lariam

  • One dose should be taken a week before departure and it should be continued throughout exposure and for 4 weeks afterwards.
  • Three doses at weekly intervals prior to departure are advised if the drug has not been used before - this can often detect, in advance, those likely to get side effects so that an alternative can be prescribed.
  • Nausea, diarrhoea, dizziness, abdominal pain, rashes and pruritis can occur.
  • Headache, dizziness, convulsions, sleep disturbances (insomnia, vivid dreams) and psychotic reactions such as depression have been reported. These reactions most commonly begin within 2-3 weeks of starting the drug and may be worse if alcohol is taken around the same time.
  • Avoid in epilepsy or if there is a history of psychiatric illness.
  • Exercise caution, and avoid if alternatives are available, in severe renal and liver failure and heart rhythm defects.
  • Also caution in those taking digoxin, beta or calcium channel blockers when arrhythmias and bradycardia can occur.
Doxycycline

Brands: Vibramycin, Doxymal

  • Can normally be used continuously for a period of at least 6 months.
  • Consider a trial course before departure, if you are using this regime for the first time, to detect if you are likely to get side effects.
  • Doxycycline need only be started just before exposure (2 days), continued through exposure and for 4 weeks afterwards.
  • Sunburn due to sunlight sensitivity can occur. Use of sunscreens is especially important and if severe, alternative prophylaxis should be used.
  • Heartburn is common so the capsule should be taken with a full glass of water and preferably while standing upright.
  • It may reduce the effectiveness of the oral contraceptive pill.
  • Taking the capsule in the evening should reduce the sun sensitivity during the day.
  • It is a good idea to take daily acidophilus medication to minimise the risk of a candidal (thrush) infection which incidentally can affect men as well as women.
  • Occasionally anorexia, nausea, diarrhoea, candida infection and sore tongue have been reported.
Atovaquone plus Proguanil

Brand: Malarone

  • Do not confuse with Maloprim
  • Should be taken for 1 or 2 days before entering the malaria area, throughout exposure, and for 7 days after leaving the infected area.
  • Need only be commenced one or two days before exposure.
  • Abdominal pain, headache, anorexia, nausea, diarrhoea, coughing and mouth ulcers can occur.
  • Absorption may be reduced in diarrhoea and vomiting, and blood levels are significantly reduced with concomitant use of tetracyclines, metoclopramide and some other drugs.
  • The proguanil component can delay the metabolism of the anticoagulant, warfarin, and result in bleeding. Those planning to take warfarin must discuss this with their doctor before starting any treatment.
  • Use with caution with renal impairment.

Summary For African Travellers and Hunters

  • Minimise the risk of mosquito bites by applying insect repellents especially at dusk when Anopheles mosquitoes prefer to bite.
  • Always travel with an adequate supply of anti-malarial prophylactic drugs and take them regularly.
  • Remember preventative measures are not 100% guaranteed. The most careful person may still get malaria.
  • Remember just a general 'unwell' feeling may be falciparum malaria and early treatment is crucial.
  • Make sure you have emergency evacuation cover which can be actioned immediately to get to at least the nearest city.

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