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Hi,

We are heading for the northern part of Kruger in the beginning of July. We never used to take Malaria prophylaxis when going to Kruger in the winter months, but this time round I think it is necessary for a few reasons. However I would like informed opinions and advice from other forumites please:

1. We plan to enter the Park at Orpen but then move north to Tsendze (camping), Shingwedzi (chalet - providing or accommodation is ready. Planned re-opening for our chalet is end of June!) . We exit via Pafuri and then end up at Mapungubwe (camping). After all the flooding, I recon these areas will have much more stagnant water than normal and for longer periods than usual. Am I right in saying that this will make the Malaria problem worse and possibly reach into the winter months, or does the lower temperatures rule that possibility out?

2. We will have our 6 year old son with us - he is my biggest concern. I did some research and it seems like Mefloquine is the best chemo-prophylaxis for young kids. It is taken orally once a week, where Doxycycline is taken daily. The latter is a nogo for kids in any way. Not sure about the other main contender i.e Atovaquone - proguanil. Is there anything better on the market I am not aware of?

I found the government department of health doc @ http://www.doh.gov.za/docs/policy/2011/malaria_prevention.pdf very informative but it obviously addresses the Malaria issue in general only, I just hope someone has more current and region specific information. thanks.

Posting your questions on this thread could also be usefull :

viewtopic.php?f=74&t=530&start=1230

I have had time share the last week in May at Ngwenya lodge for the last 13 years. My chalet is right on the bank of the Crocodile river and looks into the Kruger Park, as the crow flies my chalet is .75 of a km from the Hippo pools at Crocodile Bridge. At this time of the year the Crocodile River still has quite a bit of water in it and in the last 13 years that I have been visiting Ngwenya I have never even seen or heard a mosquito when on holiday at this time. We go into the Kruger daily virtually for the whole day and have never experienced mosquito problems in the park itself at this time. Even though the Kruger is still relatively warm the last week in May I think the cold period which sets in from about 2100 till 0700 in the morning is what keeps them away from this area at his time and through the winter till the summer rains start again in October November

Thanks ndloti, garrow. @garrow my concern is the most northern part of the Park - more than 300km north from where you are - with higher average day temperatures. My question is also related to the recent floods in that area specifcally.

Much of the advice is lengthly and ambiguous . I believe the malaria risk is over emphasised in the areas you are visiting in order to protect those offering advice .
The way I understand it is the human being is the vector who hosts the malaria parasite in which it multiplies , and thus the mosquito must transfer infected blood from one infected person to the next , thus the fewer people around the less the chance on average of contracting malaria due to the low human population densities in those areas. Northern KZN is perhaps an example to illustrate this (?) , though temperatures & the flatness of the terrain with many wetlands probably play a large role . Sanparks apparently also sprays likely mosquito areas within the camps where most visitors are at dusk when mosquitoes are most active .
It seems the experts most regularly advise to take evasive action and also to apply repellant .

Also on our way to KNP, but in summer...so malaria is an even greater risk.
We have previously taken, and will again be taking Malarone (I think it is Malanil in South Africa), the Atovaquone - proguanil tablets. From what I have read, it is the most recommended prophylaxis. I wouldn't go without it - no matter which area or which time of year, especially for children.

Malaria medication is very much a personal issue. Not just whether or not to take it but also which tablets to take. It is essential that you consult a medical practitioner who knows your individual medical history. None of the available prophylactics available are free from side effects and some people with particular medical history should avoid some of them.

For example my SO and I cannot take the same ones as we react to them, what works for him doesn't for me and vice versa.

Thanks for all the replies. Yes I recon taking Malaria tablets in an infected area is like wearing a safety belt in your car or a helmet on your bike. In many years of driving I relied on these devices only twice (one each). Like the possible side effects of chemo-prophylaxis, safety belts and helmets are not comfortable. Fact is if I did not take those precautions on the day, I would most probably not have been sitting here typing this.

Thanks ndloti for the informative info.

For what it is worth WKK, a friend of mine is a professor in infectious diseases and what he does is take precautions like covering up and sprays, and would treat any flu symptoms upon return as malaria, but has not had to yet.

It is a personal decision.

Even in the North of the park, your risk of contracting malaria during the winter months is very low. During this time we do not recommend taking antimalarials. The risk of serious adverse effects (which is not huge) outweigh the risk of contracting malaria. There is, however, still a low risk. So one should always use mosquito repellant, burn coils or mosquito plates - especially at dusk and dawn, and try to avoid mosquito bites.

At this point in time myself and SO plan not to take the tablets and be watchful for flu-like symptoms for some time after our visit. For my son the situation is different. We live on the flower-rich Cape West Coast. He is very allergic to pollen etc so very regularly shows flu - like symptoms when it is really hay-fever related. We will be returning home just as the flower season starts mid July. It will be very difficult to distinguish between flu/hay-fever/malaria in that time. Also our hospital is 160 km away so difficult to react quick enough if the fever kicks in. Sure the risk is low, but how low should the risk be before you take a chance with your child's life by not giving him the tablets? We happily survived lions harassing us in our tents last year in Kgalagadi (Bots side). Would be ironic to be bumped over by a mozzi after that experience . We don't want to deprive our kids of experiencing the wilderness, but in doing so we want to take maximum precaution as far as their safety is concerned. If he shows side effects, then we will handle it from there.

We got a prescription for Mefloquine for our son. Advantage with it is he starts taking it a week+ before departure (once weekly dosage from a week or 2 before departure). If he shows bad side-effects, there will be time to switch to Atovaquone - Proguanil (day before and then daily).

I suppose it will be nearly impossible to keep track of all Kruger related Malaria cases, since tourists contracting Malaria after visiting the Parks has no obligation to inform Parks of the illness and if there are stats available, it is seemingly not released. I was hoping for direct and recent info but as ndloti mentioned, most data is ambiguous and generalized. Thanks for all the feedback .

Everyone does some research, and makes a personal decision based on what they feel is best for them.

I would consult your Dr and hear what he has to say.