Malaria can kill if not promptly diagnosed and treated and so awareness and risk assessment are very important. Many of us may have travelled to malaria risk areas during the festive season and, with the recent rains, cases are expected to increase.
During December the National Institute for Communicable Disease (NICD) reported that for the year up to October 2018 there had been more than 16 000 confirmed cases of malaria and 110 deaths. This is considerably more than the average of 7 600 cases per year from 2007 to 2016. Based on reported cases, the Department of Health also released a revised South African Malaria Risk Map in November 2018.
Delayed diagnosis increases the risk of severe malaria and possible death. The problem is that the initial symptoms of malaria can be confused with other diseases, especially the flu. It usually starts with fever, chills, headache and body pains, and possibly nausea, vomiting and abdominal pain. The symptoms usually appear 10 to 21 days after the bite by an infected mosquito but it could be much longer.
One should, therefore, be suspicious of any of these symptoms if you live in or have travelled to a malaria area in the past six months – it is better to be safe than sorry. Report to a medical facility where a rapid diagnostic test can determine whether you have malaria or not. Should malaria be confirmed, further blood tests might be done to determine the severity of the infection. Pregnant women, young children, the elderly and those who are immunocompromised are more likely to develop severe and complicated malaria.
Medicine will be prescribed if the symptoms are still mild. If there is no improvement and the person still has a fever by the third day, or their condition gets worse, they should return to the health facility. Persons with more severe symptoms are usually admitted to hospital. The more serious symptoms of malaria include nausea and inability to eat or drink, repeated vomiting, sleepiness and confusion, inability to sit or stand, and a yellow tinge to the whites of the eyes and skin.
The bite of specific types of mosquitoes introduces the malaria parasite into the human body. Everyone should take precautions against mosquito bites whether living or travelling in a malaria area. This can be done by limiting outdoor activity between dusk and dawn, covering up with clothing and applying mosquito repellent to exposed parts of the body. Mosquito bites can be prevented indoors by spraying the house, using screens, bed nets, fans and air conditioners.
Anti-malarial prophylaxis, which is available from pharmacies without a prescription, is recommended for travellers to the moderate risk malaria areas in South Africa. This includes most of the game reserves in Mpumalanga and Limpopo. The pharmacist should advise on the best prophylaxis to take as each has its own risks and side-effects.
For more information, you can refer to South African guidelines for the prevention of malaria at www.nicd.ac.za.