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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Fri Nov 08, 2013 3:42 pm 
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Koen wrote:
SAF wrote:
Just wanted to know about KNP whether they have sprayed DDT and maybe that is the cause of the decline in malaria cases in KNP in recent time


It certainly would mean a decline and or extinction of microoorganisms, bird life, insect life, fish, amphibians, mammals.

Surely DDT has not been used since before the 1960's, hopefully never? Not in the kruger Park :|

South Africa had 64 000 cases of Malaria in the 90's up to 2000 when DDT was reintroduced :evil:

Dont know what present figures are but it could explian the death of so many crocdiles last few years, even if it wasn't used in the park itself.


Koen I read your comments and mostly agree with your sentiments, but on this have to say that DDT is not evil.

The book The Silent Spring by Rachel Carson, started the anti DDT movement and in effect was the cause of the deaths of millions of people from malaria throughout the rest of the world.

The United States tied Aid around the concept that a government must not use DDT.

Scientists have since then, shown that birds and other animals were not dying from DDT and, there is a big difference between the USA saturating crops with DDT and preventing governments in poor countries from protecting their people from malaria.

The WHO advocates the use of DDT.

In the end though, One With Nature has worked long and hard to help and advise forumites regarding malaria prevention over on the Malaria thread.


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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Sat Nov 09, 2013 5:30 pm 
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Dear Koen,

This forum is about debate and we can discuss things in a calm manner.

There is no suggestion to spray thalidomide in huts or surrounding areas where people live. I have looked at the website of the WHO and in the 60s there was an idea to combine thalidomide with other drugs to halt leprosy.

This is about DDT. We in the West must be careful of what we do in the name of the environment. The Western pharmaceutical companies developed vaccines against smallpox, polio, diphtheria, cholera, etc etc.

The environmental campaign that DDT killed insects and birds is not true. You even suggested it could have killed crocodiles.

USA does not have malaria within its borders. If it did, it would spray DDT pronto!

Quote:
It certainly would mean a decline and or extinction of microorganisms, bird life, insect life, fish, amphibians, mammals.


There is no evidence that DDT has killed these insects, birds and whatever. It was shown the egg of the bald Eagle was thinner!!

Since DDT was halted, tens of millions of people have died in Third World countries, mostly children under five years of age in Africa. It is said production and development in these countries was reduced by 40%.

Would I want my food sprayed with DDT? No not really. But as a spoiled Westerner I like to know the farm my chickens comes from.

Would I spray DDT in my home and on my land to prevent malaria? Yes I would.

Sanparks and the surrounding areas have to do the best they can for the people in danger of contracting malaria.

It is all on the World Health Website, based in Geneva with its leaders from countries around the world.

See Forbes magazine and other academics on this subject.

http://www.forbes.com/sites/henrymiller ... fantasies/

Worth reading!

The elimination of malaria in the USA. Guess what? They used DDT!

http://www.cdc.gov/malaria/about/histor ... on_us.html

Any discussion about a killer disease is serious and we have a duty not to discourage people from protecting themselves.

Anyway, perhaps we will meet up in Kruger one day. :gflower:


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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Sat Nov 09, 2013 10:23 pm 
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It seems that this discussion has drifted away from the original topic. I don't know personally of anyone who has contracted malaria following a visit to the Kruger Park, although a friend did contract it when visiting Central Africa and was in hospital for a couple of weeks.

I have worked with many people who contracted malaria during service in Burma in the war and anyone who thinks the side effects of the medication is worse than the disease is deluding themselves.

I have been visiting the Kruger for over 20 years and always take a medication, although once I took Larium and felt so ill I ended up returning to Jo'burg where I was told it was due to the side effects of the medication. However, my wife had no problems with the Larium. We now take Malarone and yes, it is expensive, but I am assured it is the most effective medication.

We also use insect repellants, plug-ins and a daily dose of gin and tonic. The latter may not protect us from the mozzies but it does help us to sleep through the noise of the fan and air con. unit.

Less than 2 weeks to our next trip - yippee!

Watchout for the hippos, which are reputed to be the second biggest killer in Africa.

bondm uk


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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Sun Nov 10, 2013 7:17 am 
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moobox wrote:
Yip. My father-in-law contracted it but years ago and I dont know if it was in KNP that he got it. He grew up on a farm in the Lowveld.

But my wife reacts pretty badly to the meds and I dont know if it is any specific type or brand. so I'm in a bit of a quandry because we are due to go to KNP in December but I dont want her to spend the time there feeling ill.



moobox, we don't take anti malaria medicine BUT we do the following: at about 4.30pm we put on long pants and long sleeve sweaters/shirts, we spray our necks (back and front),our wrists, our ankles, when it gets dark I light a Tabard citronella candle in our accommodation and outside our accommodation I burn very big sandal wood anti mosquito incense sticks (I purchased them from a 4X4 outdoor shop) and then of course we leave the fan on the whole night, that is where the liquid refreshments come into play, you need to have a few of them so you can sleep while the fan is making a noise the whole night. We are staying in Balule in Dec, so that means no electricity, but we bought a battery operated fan so hopefully we will be equipped to fight the mozzies :hmz: :hmz:

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 Post subject: Re: Malaria
Unread postPosted: Sun Nov 10, 2013 11:35 am 
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For those willing to read a bit,
copied from the WHOs website re South Africa and malaria.

Dramatic decline in malaria deaths in Africa

Scientists plan for final eradication


TDR news item
14 October 2013

With widespread use of insecticide-treated nets, indoor spraying and potent malaria medications credited with dramatically reducing malaria deaths in Africa, experts at a major malaria conference discussed the potential to use this progress as a springboard for achieving eradication of a disease that still kills some 660,000 people each year — most of them young African children.

“For the first time we have achieved very large-scale vector control coverage in Africa, and these interventions have prevented a large number of deaths and greatly reduced the burden of transmission,” said Jo Lines, a malaria expert with the London School of Hygiene & Tropical Medicine who previously led the Vector Control Unit of the World Health Organization’s Global Malaria Program. “So while there is a lot of attention still rightly focused on how we can win the battles of today or next week or next year, we can start turning our attention to the longer-term and think about what is needed to win the war.”

Lines was one of several malaria experts discussing the road to malaria eradication in Africa at the Sixth Multilateral Initiative on Malaria (MIM) Pan-African Malaria Conference - the world’s largest gathering of malaria experts - taking place in Durban, South Africa, 6-11 October 2013. Presentations at MIM, including the symposium Lines chaired on “planning for the endgame in Africa,” highlighted how scientists are transitioning from eradication as a lofty aspiration to one that involves an operational plan on the ground.

For example, researchers from South Africa discussed efforts to develop a web site dense with data on local malaria infections, part of the country’s effort to fight practically case by case to achieve its goal of eliminating malaria from the country by 2018. And researchers from Namibia presented the results from a joint effort to police malaria with neighboring Angola, an example, they said, of the cross-border initiatives that will be needed across Africa to eliminate malaria from the continent. Other researchers offered new approaches to malaria control they believe may be more “sustainable.”

According to an abstract by Chistopher Plowe with the Howard Hughes Medical Institute, vaccines are likely to be essential to malaria elimination, given that vaccines have been part of “nearly all successful” infectious disease eradication efforts and “absent from all unsuccessful campaigns.”

The elimination conundrum: making malaria get out and stay out

Lines said that eliminating malaria in Africa requires confronting a range of confounding questions. For example, he noted that increasing access to things like insecticide treated nets and artemisinin combination therapies (ACTs), while crucial to saving lives and reducing disease transmission, comes at a cost: the more they are used, the faster mosquitoes and parasites are likely develop resistance. Also, he said that while malaria transmission patterns are “changing radically” across Africa, it’s not always clear why.



“The lesson you want to learn from areas that have eliminated malaria is not just how did you drive it out but how did you keep it out."

Joe Lines, London School of Hygiene & Tropical Medicine

For example, he said his research has documented that there was a significant decrease in malaria transmission in parts of Tanzania before these areas saw widespread use of insecticide treated nets. Meanwhile, in parts of Uganda and Malawi, he said transmission has remained intense despite aggressive use of bed nets and better access to effective medications.

“We don’t know why these interventions are not working equally well in all places in Africa or why in some areas, like Tanzania, the fight against malaria appears to be aided by some other process,” he said. “We do know that when we look back at areas that have eliminated malaria, like the Southern US and Europe, we see that things like land use change, housing and human behavior played a part — potentially a very large part — in conquering the disease.”

Lines said eliminating malaria in Africa requires a better understanding of the different factors affecting transmission and also more attention to disease surveillance. Such work is crucial, he said, to ensuring that once malaria is eliminated from a particular region, it doesn’t simply re-establish itself when an infected individual migrates from areas where malaria is still common.

“The lesson you want to learn from areas that have eliminated malaria is not just how did you drive it out but how did you keep it out,” he said.

He said elimination might ultimately need to involve some way of reducing the capacity of mosquitoes or humans to transmit the parasite.

For example, there is work underway today to develop a vaccine that would interrupt the life-cycle of the malaria parasite by preventing it from passing from humans back to mosquitoes. Other efforts have focused on the potential of genetically modified mosquitoes that are rendered incapable of passing along the parasite.

Eyes on the prize: elimination via disease surveillance

In South Africa, which hopes to eliminate malaria by 2018, tracking the total number of infections, recording where they are occurring and following-up to confirm details such as travel history and symptoms is a cornerstone of the country’s elimination strategy. South Africa’s intensive malaria surveillance program includes a website that is constantly updated and features an outbreak alert system and an automated mapping program that can depict malaria cases down to the local level.

A study by Bridget M. Shandukani with South Africa’s National Department of Health found that this type of meticulous surveillance, while costly and labor-intensive, is essential to finishing off malaria in countries like South Africa that have reduced malaria transmission to relatively low levels. She and her colleagues reported that during the 2012-2013 season, all nine of the districts in South Africa at risk for malaria entered into elimination mode, “reporting local case incidences of less than one case per one thousand population at risk.”

Meanwhile, researchers from Namibia presented a study that highlights the importance of cross-border initiatives for countries targeting elimination. They noted that most of the malaria cases in northern Namibia are “imported from southern Angola.” The study examined the effectiveness of a program—the Trans Kunene Malaria Initiative—that implemented a host of interventions in a 20-square kilometer region on both sides of the Namibia-Angola border.

The interventions included long-lasting insecticide treated bed nets, rapid diagnostic tests, community education and case management. Also, both governments agreed to remove customs duties from malaria “commodities,” including bed nets and chemicals used for indoor spraying programs.

The study, presented at MIM and led by Constance Njovu with the JC Flowers Foundation’s Isdell:Flowers Cross Border Malaria Initiative, noted that both areas targeted achieved a significant reduction in malaria.

“These results show that cross-border work is both critical to elimination of malaria and possible despite (involving) different national governments with language and cultural differences,” the scientists reported.

Meanwhile, researchers from the University of Pretoria focused on developing “sustainable” tools for malaria control, which they view as crucial to creating more durable reduction in illness and death and thus a more stable platform from which to pursue malaria eradication.

A study by Leo Braack with the University’s Center for Sustainable Malaria Control (CSMC) investigated night-time mosquito biting behavior outdoors, which, given the effectiveness of bed nets, are where an increasing proportion of malaria infections occur. The study found that most bites happen at or near ground level. Braack and his colleagues concluded that simply wearing mosquito-repellent anklets “holds the potential to lower malaria incidence.”

The CSMC’s Taneshka Kruger along with colleagues at the University’s Institute of Applied Materials sought to address limits to bed nets and indoor spraying as control measures: one has to be sleeping under a bed net to enjoy its protection, they noted, while indoor spraying is costly and raises fears of exposure to toxic chemicals. They found that lining interior doors with a mesh fabric treated with a slow-releasing insecticide was a safe, effective and potentially inexpensive form of long-lasting malaria control.

The Multilateral Initiative on Malaria (MIM), launched in Dakar, Senegal in 1997, is an international alliance of organizations and individuals seeking to maximize the impact of scientific research against malaria in Africa to ensure that research findings yield practical health benefits. The MIM conference in Durban follows successful conferences held in Yaoundé, Cameroon, in November 2005, and in Nairobi in October 2009. The MIM Secretariat is currently hosted by the Biotechnology Centre of the University of Yaoundé I/Amsterdam Medical Centre.

For more information, please contact

Jamie Guth
TDR Communications Manager
Telephone: +44 79 441 2289
E-mail:guthj@who.int


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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Mon Nov 11, 2013 5:54 am 
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gabbisa wrote:
I contracted malaria in the 1990's after camping at Maroela. As we used to go so often we did not take anti-malaria tablets but did use sprays.

Going to KNP for so many years I think contracting it once is not to bad.

I would recommend however that all visitors take anti-malaria medicine, especially children.

While visiting Tanzania a couple of years ago, I found there Health Department very good. If you suspect you have malaria, you go to a hospital and they take a test and can tell you within about an hour if you clear or not.


forestgump wrote:
I have got malaria from Shipandani Hide in Kruger. I got eaten alive by the mozzies, and just knew that night that chances were good of getting it. I ended up in hospital too.


How soon did the symptoms start? Was the diagnosis made quickly?

Forest, that sounds like a very serious dose. :shock:

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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Mon Nov 11, 2013 9:28 am 
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SAF wrote:
Thanks for the responses
I am aware of Bruce Bryden, read his magical book :D
Was just wondering of people like myself visiting the park
Is anyone aware of the DDT spraying in KNP?
Heard they started spraying around 2006, if it is true anyone that has contracted after that?


In an attempt to prevent Malaria, the Department of Health often visit the park to spray houses and other tourists facilities. The KNP work closely with the Department of Health to ensure that staff members and visitors of the park are not at risk of being exposed to Malaria.

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Kruger National Park
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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Mon Nov 11, 2013 10:27 am 
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For the life cycle of the malaria parasite you need some of the following; a mosquito vector and a human infected with the malaria parasite. The larger the concentration of infected humans the greater the chance that you will find infected mosquitoes and linked to it the greater the chance of being infected. You therefor stand a greater chance of getting malaria visiting a town bordering Kruger than in a rest camp such as Satara.

Kruger falls within the high risk malaria area of South Africa as the risk is calculated based upon the malaria cases in towns neighbouring Kruger. In some of the highest risk rural communities in Mpumalanga the incidence of malaria can be as high as 20 per 1000 people (2%) (source 1). A scientific survey on travellers to Kruger in April of 1996 showed an incidence rate of 4.5 per 10 000 people (0.045%) (source 2) which is significantly lower than in surrounding towns. April was chosen as this is supposedly a higher risk malaria month in South Africa and 1996 was a malaria epidemic year.

Your chances therefor of contracting malaria inside Kruger are significantly less than going to the shops in Hazeyview for instance. This said one should keep in mind that on a good "day" the Anopheles mosquito can travel up to 12km in a night so theoretically your chances of contracting malaria in a camp/venue in Kruger that is close to a town or rural committee is larger than further away.

And as to the original question: my uncle contracted malaria while constructing roads in northern Kruger some years ago but again he was in Kruger for an extended period of time and close to the communities in the Punda Maria area

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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Tue Nov 12, 2013 10:05 am 
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Koen wrote:
Stephens.L wrote:
In an attempt to prevent Malaria, the Department of Health often visit the park to spray houses and other tourists facilities. The KNP work closely with the Department of Health to ensure that staff members and visitors of the park are not at risk of being exposed to Malaria.


What do the Department of Health use to spray "houses and other tourist facilities" with in the Kruger National Park?

Not sure what is used in Kruger but DDT is still accepted for indoor residual spraying and forms a large part of SA's control programme in especially rural areas. DDT is however not as effective on plastered or painted walls so might not be used in Kruger

At one stage South Africa stopped using it and used alternatives but the effect on the mosquitoes was not that great and it led to malaria epidemic in the country and in 2000 SA applied to the Stockholm Convention to be added to the list of countries exempt from the "ban" on use of DDT. South Africa had such great success in decreasing the incidence of malaria after this that the WHO in 2006 has done an about-turn on the use of Dichloro-Diphenyl-Trichloroethane (DDT) to fight malaria, citing South Africa's successful anti-malaria programme as evidence that controlled indoor spraying of the insecticide is not only safe, but "one of the best tools we have" against the killer disease(1).

The WHO Global Malaria Programme's guide on Indoor Residual Spraying have this statement in it: Effective implementation of IRS with DDT or other recommended insecticides should be a central part of national malaria control strategies where this intervention is appropriate.(2)

Also see:
Malaria vector control in South Africa
South Africa ALMA quarterly report
Wikipedia: Indoor residual spraying

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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Tue Nov 12, 2013 10:25 am 
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Francoisd,

You stats are very useful and put things into perspective. From what you say, around 450 visitors a year contract malaria in KNP based on approximately a million visitors.

Does rural Mozambique pose a risk as a source of the mosquitos travelling to KNP, or are the distances too far?

According to the website of The London School of Tropical Medicine, that works together with the Universities of Pretoria and Cape Town, there could be a vaccine as early as 2014.

Bill and Belinda Gates of Microsoft have financially supported the research to find a vaccine for malaria.

In the tests so far, vaccination appears to last for 18 months and small children can be vaccinated.

What a difference to child mortality.


Last edited by missings.a.! on Tue Nov 12, 2013 10:45 am, edited 2 times in total.

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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Tue Nov 12, 2013 10:32 am 
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Another interessting read from which the quote below was taken is the Health Systems Trust's 2000 report on malaria. It is worthy to note the tremedous increase in malaria incidence in KZN after DDT spraying was stopped due to the presence of the pyrethroid resistant Anopheles funestus mosquitoes. (see graph on page 5 of document)

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Vector control
The general success of the malaria control programme in South Africa to date is largely due to intensive vector control. Historically, the major vectors of malaria in this country were An. arabiensis and possibly An. gambiae, members of the An. gambiae group, and An. funestus of the An. funestus group. Individual species of each group are indistinguishable morphologically but differ in their resting and biting behaviours, which are relevant for malaria vector control. Indoor house spraying of insecticides was first started in 1932, DDT being used from 1946 onwards, and complete coverage was achieved by 1958. After the introduction of house spraying, An. gambiae and An. funestus were eliminated from all the provinces where they previously occurred, leaving only An. arabiensis as the local vector. In 1996 DDT was replaced by synthetic pyrethroids due to mounting international pressure to have DDT banned. An increasing number of donor agencies would not fund malaria control programmes using DDT, even though the World Health Organisation still supported its use in public health. Unfortunately Anopheles funestus has recently been re-discovered in KwaZulu-Natal and has also been found to be resistant to synthetic pyrethroids. Resistance in this species was also found in neighbouring areas in Mozambique, where no vector control had been carried out at all. e This species, due to its habit of breeding in permanent water bodies rather than temporary puddles, tends to be associated with all-year transmission, a possible contribution to the tremendous increase in winter malaria observed over the past few years. In the winter of 1999 the control programme in KwaZulu-Natal therefore re-sprayed all houses in this region with DDT, and it will be used for the 2000-2001 malaria season as well. Pyrethroids will be used in the other two malaria-affected provinces of Mpumalanga and the Northern Province.

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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Tue Nov 12, 2013 4:29 pm 
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Have not read all the correspondence but a friend contracted Malaria from a June visit...so its possible to get at any time of year....obviously some eyars are worse than others!

:sniper:


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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Wed Nov 13, 2013 2:15 pm 
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francoisd wrote:
missings.a.! wrote:
From what you say, around 450 visitors a year contract malaria in KNP based on approximately a million visitors.

Rather from what the research article say :) and do remember that it was done during a period when there was a marked increase in malaria cases, since 1998 the annual total of cases decreased close to three times so assume the number of cases of travelers to KNP contracting malaria have also decreases significantly.

I don't think that the rural areas of Mozambique play a large part as most are to far and on some parts there are "mountains" in the way. I rather think that humans travelling between the countries or from higher risk areas in SA play the largest role as reservoir hosts that then serve as source of infection for the mosquitoes. But then again I am not a malaria researcher.



Thanks Francoisd.

I did think that the numbers may be smaller but then again, maybe some people are not reporting back.

The fact is though that as you said, visitors must make the effort to protect themselves.

Just read in the Wall Street Journal that the President's fund, set up by GW Bush, donates Malaria medication free of charge to Sub Saharan African countries and around 15% of the medication is being stolen and sold on the black market in other countries.

Prophylaxis intended for Tanzania is available for sale on the streets of Angola.

A problem is if the drugs are not stored in the correct temperature, it can reduce their efficacy and help to create further immunity to the drug.


Last edited by missings.a.! on Wed Nov 13, 2013 3:49 pm, edited 1 time in total.

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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Fri Nov 15, 2013 8:27 am 
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I know of only two people who contracted Malaria in the last 10 years. One friend went for a golf tour to Palaborwa and was there for only one day. Got diagnosed with sun stroke to weeks later, by the time they realised it was malaria he already had black water fever. Luckily he survived but it took months/years to properly recover. Then we have a house in Sabie park right at the Kruger gate which we share with friends. Because we go so often we don't take any prophylaxis, just use the normal bug spray etc. About 4 years ago the co-owners wife contracted malaria. So we are really careful and vigilant especially in summer.

Then this probably doesn't count, my cousins all grew up in Skukuza/Pafuri so they all contracted malaria as kids but this was in the early 90's, so many moons ago. My aunt however contracted bilharzia when living there and it only showed symptoms and got diagnosed almost 20 years later.

I guess at the end of the day you just got to be careful and keep watch should you get sick.


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 Post subject: Re: Have you or anyone you know contracted malaria in KNP?
Unread postPosted: Fri Nov 15, 2013 8:57 am 
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RemiE wrote:
Herman wrote:
francoisd wrote:
For the life cycle of the malaria parasite you need some of the following; a mosquito vector and a human infected with the malaria parasite. The larger the concentration of infected humans the greater the chance that you will find infected mosquitoes and linked to it the greater the chance of being infected. You therefor stand a greater chance of getting malaria visiting a town bordering Kruger than in a rest camp such as Satara.


Only humans or any mammal ?


Would really appreciate if someone could shed some light on this... :hmz:


From the Malaria Vaccine Initiative website.

Quote:
Malaria vaccine researchers also need challenge models. Given that P. falciparum malaria does not naturally infect commonly used laboratory animals, developing a challenge model for the malaria parasite has required special centers where human volunteers are deliberately infected or “challenged” with malaria to observe whether a candidate vaccine can prevent or delay an infection. In this regard, MVI is supporting the Malaria Clinical Trials Center at the Seattle Biomedical Research Institute, one of only half a dozen facilities of its kind worldwide. (See Sidebar: MVI Invests in Human Challenge Center).


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