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onewithnature wrote: I have, from time to time, been making fairly comprehensive contributions to malaria and its prevention on other threads on the SANParks forum, so I am not going to give extensive details on everything discussed above today, but would indeed like to add comments where appropriate: Quote: Quote: While the risk of malaria is low in both Kruger National Park and Mapungubwe National Park, the risk is there, so if you go to either park you should know what to do. Firstly, this statement covers the malaria risk areas amongst the SANParks reserves, but these are not the only malaria risk areas in Southern Africa (I am concentrating on this part of the world because this is the areas that we are dealing most with here on the forums): for example, several areas of Kwazulu-Natal have malarial risk (although mostly low- and medium-risk); parts of Swaziland and some northern parts of Botswana are also seasonal-risk areas, as is Kruger and Mapungubwe; and some countries, like Mozambique, are high-risk areas all year round; while some areas bordering and near Kruger Park and Mapungubwe also contain malaria-infection potential, although generally of a low-risk nature all year round. NOTE: For detailed areas of malaria risk in Southern Africa (and of course anywhere in the world), please consult a competent and up-to-date malaria-risk map!
Secondly, defining a low-risk malarial area depends on the number of reported cases of malaria found in that area. The high-risk season for malaria in both Kruger and Mapungubwe (end of September until end of May) is considered relatively low-risk as compared to all-year-round high-risk areas like Mozambique, most of Tropical Africa, Malawi, and so on. As stated, the risk is lower than many other countries with malaria risk, but it is not wise to ignore that risk.
Thirdly, risk of contracting malaria may rise in some susceptible people, depending on, for example, age, health, how often you get bitten, and when you get bitten.
Quote: Quote: Especially pregnant woman should do so [get appropriate and competent professional advice], your baby is at risk! Also keep in mind that children under 5 kilos can not take antimalarials, so the only protection they have is mosquito repellant soaps and spray..
Because the unborn foetus and young children are particularly at risk of morbidity and mortality from contracted malaria, the first recommendation for pregnant women and young children is NOT to enter a malaria-risk area unless it is absolutely necessary. If the latter, then every suitable non-drug, plus chemoprophylactic (antimalaria medication), measure must be used to prevent contracting malaria; and only after thorough and competent professional advice has been received.
Quote: Quote: Malaria is transmitted by the bite of an infected mosquito, these mosquitoes usually bite between dusk and dawn, in the night. To avoid being bitten, remain indoors in a screened or air-conditioned area during the peak biting period.
It is the female anopheles mosquito that may transmit malaria, and she mostly bites between dusk and dawn, with peak biting periods usually closer to midnight, and again in the early hours of the morning prior to dawn. These mosquitoes usually enter human dwellings from around 5 p.m. - 10 p.m., and again in the early hours of the morning, and biting begins anywhere from dusk until dawn. Try to avoid going outside at these times and stay inside a suitably protected dwelling (e.g. intact mosquito nets on the doors and windows, anti-mosquito mats, use of citronella products, and so on).Quote: Quote: You may have heard that taking antimalarial drugs masks the actual malaria. This is not strictly true, but it is harder to diagnose as for instance the parasite count is lower. So if you have malaria-like symptoms have you medic look twice. The malaria itself will not be as severe, and recovery is quicker.
Antimalarial drugs - taken correctly - do significantly reduce the risk of contracting malaria, although they do not prevent the disease a hundred-percent of the time! Hence the necessity of using non-drug measures despite being on chemoprophylaxis. If you are one of the unlucky ones to still contract malaria despite taking antimalarial drugs and suitable non-drug measures, the initial diagnosis of the disease may be more difficult to determine. However, as time goes on, the disease may still progress, until it may indeed become as severe and as dangerous as someone who has not taken any precautions. The advantage in taking antimalarial drugs is that recovery is often quicker when malaria is diagnosed, as the parasite count may be lower than in someone who didn't take these precautions. ALWAYS take all drugs correctly, diligently, and finish the courses as required.Quote: Quote: Malaria is always a serious disease and may be a deadly illness. Travelers who become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after returning home (for up to 1 year) should seek immediate medical attention and should tell the physician their travel history.
Most people who contract Falciparum malaria (generally the most deadly form of the disease) notice malaria symptoms within a few days to a couple of months after entering a malarial area. Chemoprophylaxis, as discussed above, may delay presentation of these symptoms. However, it is indeed safest to adequately test for malaria up to six months, and even one year, after entering a malarial area and presenting with flu-like and other malaria symptoms. People who are in a malaria-risk area (and especially an all-year-round high-risk area) for extended periods of time (weeks, months, or years) should consult a competent medical professional as to what is the best antimalarial measures to use under these circumstances.Quote: Quote: For the best protection against malaria, it is important to continue taking your drug as recommended after leaving the malaria-risk area (4 weeks for mefloquine, doxycycline, or chloroquine, 7 days for atovaquone/proguanil or primaquine). Otherwise, you can develop malaria.
Please note that there are only a few places in the world where chloroquine as a preventative antimalarial drug is still recommended, as many places have developed significant chloroquine-resistance; in other words, taking chloroquine will, in all likelihood, have a reduced potential for preventing malaria infection in these places. Because of this, the World Health Organisation and the South African Department of Health do not anymore recommend that chloroquine be used first-line to prevent malaria in malaria-risk areas in Southern Africa, and indeed Africa, and also many other parts of the world. (Again, consult an up-to-date malaria risk-areas map, as well as appropriate preventative information for each area.) Please, therefore, be very wary of using chloroquine as an antimalarial preventative in chloroquine-resistant areas. It has been argued that chloroquine will still provide some protection against acquiring malaria in chloroquine-resistant malarial areas, but there are several other antimalarials that will give significantly better results in this regard, and so are recommended first-line by competent sources. The article above suggests mefloquine, doxycycline, and a proguanil/atovaquone combination, and these are indeed first-line recommended antimalarials in chloroquine-resistant areas like Southern Africa. Always make sure you consult a competent, knowledgeable medical professional for obtaining the antimalarial most suited to your needs because (potential) side-effects, contra-indications, concomitant medical treatment, and other appropriate factors, may mean that you are better off with one of these rather than the others.
Disclaimer: My recommendations here - though based on some experience and some drug, and other, knowledge - are not absolute, and further consultation with suitable health-care professionals is suggested before a final decision is taken on whether to enter a malarial area, what prophylaxis to use, and any general factors and limitations that need to be taken into account. Furthermore, I only advise based on what information is given by the person(s) entering the malarial area, but I have no control on the information given to me, and so such information could possibly be incomplete or misleading. Moreover, people vary subjectively as to how they metabolise, and react to, drugs and other substances, which further accentuates that my suggestions here are only general suggestions, and therefore not to be taken as pertaining to every person alike.
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He is rich or poor according to what he is, not according to what he has. ~Henry Ward Beecher
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