Malaria: A dangerous but avoidable disease

Malaria is a dangerous disease and should not be underestimated. Despite efforts to combat malaria, it continues to kill over one million people a year, mostly children under the age of five, while making many others sick and unproductive. The overwhelming majority of deaths from malaria occur in Africa. Those who live in or travel to malaria areas should take steps to protect themselves and their families from the disease. 

The South African Development Community (SADC) Malaria Week is commemorated 8 - 12 November 2010. As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate our members and future members on a range of healthcare topics, we would like to provide you with some information on this disease and its prevention.

SADC Malaria Week aims to create awareness about malaria and mobilise the community to participate in malaria control programmes. The initiative believes that the community should be mobilised through education to:

• Recognise the signs and symptoms of the illness;
• Provide more home based treatment;
• Seek treatment when individuals become ill; and
• Take personal protective measures against the illness.

What causes it?
Malaria is caused by the bite of the Anopheles mosquito. The disease is endemic in the northern parts of South Africa, confined to places such as the Lowveld of Mpumalanga and Limpopo as well as on the Maputaland coast of KwaZulu-Natal. Malaria is also found in parts of other southern African countries such as Mozambique, Zimbabwe, Namibia and Malawi. In South Africa both the mosquito and the disease it carries are most common during the summer, rainy season.

Travellers to these regions should be careful to protect themselves from the disease. Many people who live in malaria areas develop a partial immunity to the disease. However, this partial immunity is lost after a person lives in a malaria-free area for a period of a year or more. Those individuals who are returning home after spending time in malaria-free areas should therefore also take care to avoid getting the disease.

What to watch for
The symptoms of malaria may be varied and include headache, fever, diarrhoea, muscular and joint pains, sweating, fever, nausea and fatigue. These symptoms usually occur between 10 and 15 days after an infected mosquito bites you, although sometimes they only appear some months later. You should therefore watch out for any of these symptoms and immediately visit your doctor should they appear. Do not make the mistake of thinking you just have flu or some other mild illness and that it will go away on its own. Malaria that is left untreated may become complicated and can be very dangerous.

Preventative medication
There are a number of different ways to avoid getting the disease, and those travelling to a malaria area should establish whether they will need to take a preventative medication or prophylaxis before leaving.

Prophylaxis does not necessarily stop a person from getting malaria, but it can stop the illness from becoming serious. Malaria prophylaxis is an important tool in the fight against malaria and travellers should certainly consider using it if they are going to a malaria area.

Speak to your doctor or travel clinic to see whether you need to take a prophylaxis before travelling. They will also advise you on how you should take the medication and it is important to follow their instructions carefully. It is important to note that some types of prophylaxis need to be taken a week prior to your departure, so do not leave your visit to the doctor too late. Prophylaxis should be continued for a month after returning from a malaria area.

Preventative measures
Travellers to and residents in malaria areas should do everything in their power to prevent themselves from getting bitten by mosquitoes. There are a number of repellents and insecticides on the market that can help to achieve this.

Residents in malaria areas should cooperate with all official spraying programmes which destroy large numbers of mosquitoes and help to prevent people from getting the illness. The following are some steps you can take to ensure that you don't get bitten by malaria carrying mosquitoes:

• Mosquitoes are generally more active between dawn and dusk and people should be more cautious about getting bitten at this time;
• If possible, remain indoors when mosquitoes are active;
• Try to get mosquito screening for your doors and windows. Unless they are screened, keep windows and doors closed at night;
• Apply insect repellent to exposed skin. Repellents should contain the ingredient DEET;
• Spray an aerosol insecticide inside your living and sleeping areas;
• Burn mosquito coils or run electric mosquito mats in living and sleeping areas;
• A new repellent in which you can wash your clothes and other fabrics is reportedly effective in helping to repel mosquitoes;
• Sleep under a bed-net that is treated with repellent; and
• Wear long-sleeved shirts, long trousers and socks if outdoors when mosquitoes are active.

High-risk individuals
Some people are at high risk of developing serious complications from malaria and cannot take prophylaxis to help protect themselves. These people should avoid malaria areas altogether. If this is impossible or they live in a malaria area, they should take special precautions not to be bitten by mosquitoes.
 
People who should not travel to malaria areas or who should take extra precautions if they live in malaria areas include:

• Children under five years of age;
• Pregnant women;
• Adults over the age of 65;
• People living with HIV, epilepsy or porhyria;
• Cancer patients receiving chemotherapy.

Much can be done
Malaria is a dangerous illness but people can do much to ensure that they avoid contracting it. Take the necessary precautions and it should not trouble you. And finally, get to a doctor if you think you may have malaria. Early treatment can ensure that it does not cause you serious complications.

For any GEMS member queries, please contact the GEMS call centre on 0860 00 4367 or visit our website at www.gems.gov.za. GEMS will assist you in every way possible to ensure your family's health and wellbeing.

References

1. ‘Malaria Information', Malaria in South Africa, www.malaria.org.za.
2. ‘Malaria', World Health Organisation, www.who.int/topics/malaria/en/.
3. Malaria Journal, www.malariajournal.com/.