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Malaria Survival Guide

Prophylactic measures to prevent malaria
It is important to note that no preventative measures are 100% safe. Should flu-like symptoms and signs of malaria like body pain, headache and fever develop 7 to 20 days or more after visiting a malaria area, you should be tested daily for malaria until you are better or another diagnosis is made.

Malaria is one of the most serious and common tropical diseases in the world. However, there is no reason why this disease should deter you from coming to the Kruger National Park if the necessary precautions are taken. If precautions are not taken and/or if the disease is not diagnosed and treated early, malaria is potentially fatal.

Malaria can be prevented

The most important and most effective way of preventing malaria is firstly to prevent mosquito bites. The following preventative measures can be taken:
  • Remain indoors from dusk to dawn if possible as malaria mosquitoes usually feed in the early evenings and mornings.
  • Cover your arms and legs towards evenings with light coloured clothing to cover exposed skin areas and especially the ankles. Wear long sleeved shirts, long trousers, socks and closed shoes.
  • Apply insect repellents to exposed skin areas every 4-6 hours.
  • Burn insecticide coils or electrically heated insecticide tablets in the bedroom at night.
  • Spray knock-down insecticide for flying insects inside the bedroom in the early evening with windows/doors closed if there are no window screens.
  • Screened mosquito proof windows and doors and mosquito nets guard against mosquito bites.
  • Clothes and nets impregnated with Pyrethroid could be used.
  • Another way of preventing malaria is to take additional preventative drugs when visiting an endemic malaria area, especially in the warm and rainy months from October to May.
  • Your doctor will prescribe the preventative medication of choice for you before visiting the Kruger National Park and surrounding areas.
Chloroquin is taken on a weekly basis and Paludrine daily.

The first dose of Chloroquine should be taken a week before entering a malaria area to see if there are no serious side effects. Paludrine can be taken 2 days before entering the malaria area. It is important to continue to take the medication during your stay AND FOR FOUR WEEKS after leaving the malaria area. It is advisable to take the medication at night with food to reduce side effects like nausea.

Mefloquin is an alternative to the Chloroquin / Paludrine combination and it is the drug of choice when visiting other areas such as Zimbabwe and Mozambique if there are no contraindications for using Mefloquin. If the Chloroquine/Paludrine combination or Mefloquin cannot be used, DOXYCYCLINE on a once daily basis can be taken after meals as a preventative drug.

Visit your general practitioner for advice on the correct dosage according to age and weight. Discuss if any of the medications are contraindicated (ie. in infants, young children, pregnancy, patients with psoriasis, porphyria or epilepsy).

Malaria in pregnancy, infants, small children and other special cases

Despite the fact that the South African National Department of Health recommends that pregnant women should preferably not visit a malaria area, many pregnant women do visit a malaria area and even live in the Kruger National Park. Extra care for preventing mosquito bites should be taken as malaria in pregnancy holds an increase in risk for both mother and child.

Your doctor will discuss the appropriate medication for you.

It is important to take the medication during and for four weeks after leaving the malaria area.

The following people should, if possible avoid visiting malaria areas - or take extra care in preventing mosquito bites.
  • Cancer patients on chemotherapy
  • Persons on long term steroid therapy
  • Persons whose spleen have been removed
  • Persons with full blown Aids - it is not contraindicated for an HIV positive person to visit a malaria area.
  • People suffering from porphyria must not use Doxycycline. In this case, the combination of Chloroquin and Paludrine is probably safe to use. The safety of Mefloquine in porphyria has not been established. People with epilepsy should take care when using Chloroquin. Mefloquin is contraindicated in epilepsy. Pilots and mountaineers should not take Mefloquin as it could impair balance.
Malaria symptoms
If you develop influenza-like symptoms, such as body pains, headache and fever, 7 to 20 days after visiting a malaria area you must be tested for malaria immediately.

Ensure a safe and care-free stay in the endemic Malaria area CALL THE 24 HOUR PHONE-IN LINE 082-234-1800 for information about the current Malaria status, prevention, prophylaxis, symptoms and signs.
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