The African bush and malaria are and an
almost automatic association. At one time the northern areas of
KwaZulu-Natal were viewed as downright dangerous. Early maps of malaria
risk in South Africa show St Lucia as being the only area in the country where
you could get malaria at any time of the year. Of course things have
changed a great deal since then but one needs to keep looking at the
situation critically.
Your chances of getting malaria as a
tourist depends on many things, including the amount of malaria in the
population of the surrounding area, the measures you take to protect
yourself, the time of the year and the recent rainfall.
How do things look in KwaZulu-Natal now? In general
good and looking towards the future there is hope for improvement.
Self Help and Malaria Prophylaxis
Public health measures reduce the risk of
malaria but don't guarantee that you the visitor will be safe from
infection with malaria. Unfortunately there is not much new in the way of
chemo prophylaxis. The current recommendations are Larium (Mefloquine) or
the combination of Daramal (Chloroquine) and Paludrine (proguanil) or
doxycycline.
Don't loose sight of other personal
protection measures. You should never visit a malaria without taking along
an effective repellent. This excludes citronella and any of the other
naturals which only repel mosquitoes for a short time. Numerous studies
have shown that the most effective repellent is Diethyl toluamide usually abbreviated
to DEET. Mosquito coils are very effective in rooms or huts as are
electrically heated pads containing insecticide. Sleeping under a mosquito
net will prevent mosquito bites at night and long armed shirts and trousers
is effective in evenings and mornings while not in bed.
Public Health issues in combating Malaria
In essence this is about the health of the
people live in the area. Cost considerations mean that these people cannot
afford prophylaxis. Few can even afford nets for their beds. As such they
are reliant on the Malaria Control Programme to reduce the probability of
getting malaria and the services of the local clinics and hospitals to
cure them if they get infected.
Effective treatment of the disease is
paramount. Any resistance in the parasite means the patient goes home
uncured. He then has a resistant strain of malaria which will intern
infect mosquitoes with the resistant malaria strains.
But drug resistance is not the only part of
the malaria combat equation. Mosquito numbers must be limited. Since the reintroduction
of DDT the mosquito populations are effectively being held in check.
The future of Malaria Control
It is no coincidence that the malaria risk
is highest on our borders with our neighbor Mozambique. During the
countries recent tragic history one of the victims was effective
malaria control. Recently Malaria control has become reintroduced and the
nock-on effect has already been noticed in Mpumalanga, Swaziland and
KwaZulu-Natal.
It will still be a number of years before
an effective vaccine is developed so don't hold you breath waiting for
that.
