How to prevent Malaria when travelling in Africa

Africa is an amazing travel destination – safari, the Big 5, the exquisite, the wild, the untouched call of nature. A mind-blowing travel experience for all. However, no one wants to get ill, and malaria is a very real risk. Armed with lots of knowledge and practical safety tips, you can eliminate or minimise any risk of you or anyone in your family or travel party from getting malaria when you travel in Africa. By understanding exactly what malaria is, and how you can make sure you and your family stay safe from malaria, you empower everyone. Learn here about how to recognise and treat the symptoms quickly if you do happen to be ‘bitten’ by a malaria critter.

Malaria can be easily avoided and quickly treated or debilitating and life-threatening. You can make sure you and your nearest and dearest can ultimately avoid, or quickly treat malaria.

Here, you can learn:

1)     How do you get malaria?

2)     Top tips to prevent malaria when travelling in Africa

3)     How can I protect my children and the elderly from malaria when travelling in Africa?

4)     What are the first symptoms of malaria, the different types of malaria and how long before malaria symptoms show?

5)     How do I treat malaria?

6)     What are the most common malaria areas in Africa?

1) How do you get malaria?

You can get malaria by being bitten by a tiny, annoying, buzzing insect – the mosquito.  The female of the species is way more deadly than the male. The Anopheles female mosquito is the culprit.

She will have to have previously bitten an infected person, drawn a tiny amount of blood, and then transferred microscopic parasites (around 7 days later) into her next victim. The parasites, mixed with the mosquito’s own saliva, are then quietly pierced into the next victim’s skin.

Once bitten and malaria is present in a human, it is found in red blood cells, and can be transmitted by:

• Blood transfusion
• Organ transplant
• Shared use of needles contaminated with blood
• Pregnant mother to unborn infant

Malaria is not contagious, i.e. you can’t get malaria by sitting next to or touching someone who has it.

2) Top tips to prevent malaria when travelling in Africa

That’s the scary bit. You need not worry about it ‘though, because forewarned is forearmed when it comes to malaria in Africa. Take reasonable precautions, and you will never have to suffer the consequences of chills, fever and malaria. It is very easily avoided, thank goodness.

The best way to avoid getting malaria, is to be vigilant about not getting any mosquito bites in the first place.

You can do this by:

• Being aware of when mosquitos are biting. This is usually at peak in the dawn, the dusk and in the evening, when it is cooler. You can avoid these times outdoors, but I doubt you will want to as these are the best times for spotting animals. So, during these times it is important to use an insect and mosquito repellent spray. This is also good for any other critters, besides mosquitos. There are many insect repellent sprays on the market that use less of the chemical ingredients (kinder to kids and skin) and more natural ingredients, such as citronella oil. Find one that suits your skin and your family and use it liberally on any exposed areas of skin, especially in the early morning, at sundown and in the evening. Effective brands are Tabard, Vital Protection and Peaceful Sleep.

Make sure to spray the sleeping area with insect repellent before bedtime, for extra protection.

• Covering up. Don’t let the balmy temperature at dawn and dusk fool you into exposing skin. Wear long sleeves, and long pants. Get yourself some lovely, light cotton ones. You will look so cool. Yup, tuck your long pants into your socks. Wear closed shoes and a hat. It’s ok, it’s fashion on safari. Plus, very wise, as you don’t want a nasty bite on your ankle or wrist to result in malaria, do you?
• A mosquito bed net. Does your accommodation include mosquito nets over the beds? If not, bring your own. You can buy pre-treated mosquito bed nets, with a pyrethroid insecticide included. Or just buy a mosquito net, and get it treated after you have bought it. If it reaches the floor of your bed, great. If not, tuck it under your mattress. The idea is not to let the critters through when you are sleeping.  Most accommodation in malaria areas in Africa will supply pre-treated mosquito nets, so be sure to enquire of your accommodation manager, and if in any doubt, take your own.
• Air conditioning – If you are staying in a hotel or room with air conditioning, keeping the temperature down and the bed net on will stop the prevalence of mosquitos.

Another consideration is that of taking anti-malarial medication prior to and during your travels. Each person travelling needs to have an individual rick assessment and a decision made as to whether to take anti-malarial medication or not, and which medication to take.

This assessment should be done by a Doctor, preferably one who knows the patient’s history. Anti-malaria medication can cause nausea and other unpleasant side effects such as depression and headaches. The older versions of anti-malaria medication such as Larium are more likely to cause side effects, whilst newer daily versions such as Malanil or Malarone have reportedly far fewer side effects. However, they are also considerably more expensive.

Most regular travellers into malaria areas choose to forego malaria medications and rather focus on taking precautions to avoid being bitten. This is to avoid taking medication too often.

The best way to make the decision is with your healthcare provider in your home city. They will need to take into consideration:

• Any other medical conditions
• Other medications that are being taken and how they will react with the malaria medication
• Risks involved in the specific itinerary you have chosen for traveling – which areas are you going to? What type of accommodation will you be staying in?
• Which season will you be travelling in?
• What are the additional risk factors, such as age or pregnancy

If possible, it is best to avoid malaria areas while pregnant and breastfeeding.

Always purchase your malaria medication from your home country, and before travelling. This way you can ensure you are using a brand that has been approved in your home countryand has been recommended by a qualified healthcare practitioner.

3) How can I protect my children and the elderly from malaria when travelling in Africa?

The truth of the malaria matter is that the very young and the very old will suffer the worst if they do get it. Travelling with young children (under the age of 7) and the elderly (over 60) means taking extra precautions in terms of insect repellent, clothing and exposure time to mosquitos.

The same tips as above apply to the very young and old, with extra vigilance!

Experienced travellers to malaria areas suggest three crucial steps:

• Do everything you can not to get bitten in the first place
• Seek immediate attention and early treatment if any symptoms develop
• Take prophylaxes approved by your own Doctor

4) What are the first symptoms of malaria, what are the different types of malaria and how long before malaria symptoms show?

Malaria can present itself in different ways, over different time frames up to a year after being bitten, so travellers need to be super aware of symptoms and time frames. Malaria can range from an unpleasant 24 hours and quick recovery to an extremely serious or even life-threatening disease.

Most malaria symptoms start with a feverish and flu-like set of symptoms that be uncomplicated or severe. Malaria is generally curable if diagnosed and treated quickly. Cerebral malaria is the most severe and has a higher mortality than other types of malaria.

It is particularly important to be aware that symptoms might not show immediately, in fact they will most likely only show between 7 – 30 days after being bitten by an affected mosquito. Which means that many travellers will have returned home believing they are healthy, before symptoms show. Anti-malaria medications taken can also delay symptoms for up to months.

Healthcare practitioners who do not know that you have travelled to a malaria area could very easily misdiagnose a patient, so be 100% sure to inform them that you have travelled to a malaria area. Please insist on being tested for malaria, as this is one of the easiest ways to mis-diagnose and treat malaria – the time elapsed between travelling, being bitten and showing symptoms is varied and can be very long. Even if a previous test for malaria has proved negative, and you have any symptoms, insist on being re-tested.

Types of malaria:

Classical / Uncomplicated Malaria

This usually lasts between 6 to 10 hours and presents similarly to a bad bout of ‘flu.

The symptoms include:

• Body aches

The symptoms can (but do not necessarily) go through 3 phases consisting of:

• Feeling cold / shivering
• Getting hot, feverish, headaches, vomiting and possible seizures in young children
• Sweating, a return to normal body temperature, followed by extreme tiredness.

Other physical effects can (but do not necessarily) include:

• High temperature
• Enlarged spleen
• Elevated respiration

Diagnosis is by blood testing showing parasites in the blood, but many people who are familiar with malaria will diagnose themselves.

Severe malaria

Severe malaria is a medical emergency and treatment must be fast and aggressive. Severe malaria can include many complications such as:

• Respiratory distress
• Low blood pressure
• Low blood glucose
• Metabolic acidosis (high levels of acidity in bodily fluids)
• Permanent kidney injury

Cerebral Malaria

This is a very severe type of malaria characterised by neurological effects, abnormal behaviour, coma, seizures and loss of consciousness.

Relapsing Malaria

A recovered malaria sufferer can experience a sudden relapse over months or even years after recovery.  This is because dormant liver parasites can remain, even after treatment, and become active again. If you have had a malaria attack, you need to request additional medication after recovery to minimise chances of a relapse malaria attack. In addition to being aware of the fact that a relapse could occur.

How do I treat malaria?

The initial diagnosis is key. Anyone who has a fever and has travelled to a malaria area within the last year MUST insist on being tested for malaria.

Treatment for malaria is not a ‘one size fits all’ situation. Diagnostic tests and information that your doctor will need in order to prescribe the best course of medication include:

• Disease severity
• Parasite Species
• Where the infection took place
• Resistance to anti-malarial drugs in that region
• Age and weight
• Pregnancy status

The Centre for Disease Control and Prevention (CDC) has a 24 hour helpline for clinicians in the US.

5) What are the most common malaria areas in Africa

There are five parasite species – Plasmodium falciparum, ovale, vivax, malariae and knowlesi. The disease is prevalent in Africa, where around 1 million people die of malaria every year, with a high percentage of those deaths sadly being children under the age of 5.

Some popular tourist destinations in Africa where malaria is present:

• Tanzania and Zanzibar
• Ghana (all over country)
• Mozambique (all over country)
• Botswana (especially North west, Chobe National park and Central Botswana)
• South Africa (especially Limpopo, Kruger National Park and Mpumalanga)
• Kenya (especially North Eastern and Coast)

In the Southern hemisphere of Africa, malaria prevalence is highest during warmer and wetter months of November through to April. For May through to October, the risks of acquiring malaria are reduced, but not eliminated.

In summary:

Malaria is a very avoidable and treatable disease and should not stop you and your family from enjoying delightful travels in Africa. Red flags and the biggest area of concern is protection of young children, babies, the elderly and pregnant women, and extra precautions should be taken for these groups while travelling in Africa.

Avoiding being bitten by mosquitos is the best form of defence, and involves being vigilant at dawn and dusk, wearing long sleeves, scarves and pants, using insect repellent and sleeping under mosquito nets.

The next best defence is to get medical treatment and testing for any symptoms of fever and flu-like pains, by informing your healthcare practitioner of where you have been and insisting on a malaria test, even up to a year after returning from the malaria area.

Here’s to safe and happy African travels for all!