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 Post subject: Re: Are we being stupid ?
Unread postPosted: Sat Nov 13, 2010 9:35 am 
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renervr wrote:
Sory but I'm going to step on some toe's :pray:
As both my wife and I being medical specialists we must then have been seriously ignorant and dof regarding risks. My son [20yrs] had his first visit at 16 days old for 2 weeks and my daughter[17yrs ] had her first visit at3 months old and ever since visiting at least 5-8 times a year.Nobody ever used malaria tablets and good old Tabard Peacefull sleep and in the rooms mozie mats protected us for all these years.
I stand amazed at all the old wife tails and urban legends!?
With a bit of lateral thinking you ask the qeustion how many thousands if not hundreds of thousand babies live in the eastern areas with the mozies and the heat!Yes there are many malaria cases but once again the studies tell the storie that in 98% of cases not a single type of precaution used!
In 21yrs of practice [x2 including my wife's practice] I had one malaria case from Kenya
referred to me because I do high risk obstetric manegment.At least once a month we hear of a fatal incident of one of our patients be it motor accident [99.9%] robbery etc



Many people are indeed ignorant, or sometimes unwise and insufficiently cautious (which usually stems from ignorance!) about the risks of malaria - and this traverses the entire range of people, from professionals to non-professionals, foreigners to locals, adults to teenagers, those in the know and those not! I've come across all types of people who prefer not to use antimalarial drug prophylaxis (known as chemoprophylaxis) for various reasons. Often, it is indeed not having sufficient knowledge about malaria, how to prevent it, the risks involved, how to suspect and diagnose it, and how to treat it. These people can then be sufficiently educated, whereupon their approach to malarial prevention (and, if necessary,

However - and this is what often amazes me - there are many people who know that malaria can kill - are sufficiently educated - yet they almost disdainfully ignore the risks!! :huh: Many, I believe, walk with that age-old fallacy: it will not happen to me! Poppycock!!

EVERYBODY WHO ENTERS A MALARIAL AREA IS AT RISK OF CONTRACTING MALARIA!!!

Sure, people have different responses to the disease - for instance, some have partial immunity and develop milder symptoms (but that is only partial immunity and does not guarantee them safety from death at the hands of this tragic killer!), some are immunocompromised (lowered immune system) and face higher risks (including young children and babies, those on chemotherapy, etc.), and some do not get infected with the most lethal and common strain, P. falciparum, but P. vivax, P. malariae, or P. ovale. Some people are even lucky enough not to get bitten by a single mosquito during their stay, and different people are bitten more than others in general.
However, everybody is at risk of contracting malaria when entering malarial area, and that is an important point to keep in mind. You may think you are protected because of your religious beliefs, or family history of no-one ever having contracted malaria, or whatever, but the bottom line is that malaria is still a rife killer in the world, and especially in children 5-years and younger! It is not about bravado, but caution and wisdom, that is essential!

Renervr, I understand that you and your wife, from a clinical perspective, have not seen cases of malaria (bar one referred) in over 40 combined years of practice. You are fortunate, but your two medical practices by no means determine the statistics of your province, let alone South Africa or the world! As medical professionals, you must know that malaria is lethal and that millions of people die from it annually! Lateral thinking does not even enter into the equations, as the only thing that must be of concern to all people is the tragic loss of life - the statistics - due to malarial infection. Many people who die of the disease are indigent and in remote areas of Africa, and so have little or no access to medical prophylaxis and/or treatment when they do get the disease! Relatively affluent people mostly do not live in high malaria risk areas, have access to knowledge and information, and can obtain treatment for the disease if needed! I have no idea where your practices are (were), but there seems little doubt that they were not in high-risk malarial areas and that you did not see many indigent, or poor, people who have come from high-risk areas.

You don't specify which malarial areas you took your infants to, but it is well to remember certain points pertaining thereto: there are low risk areas, there are high risk areas, and there are very high risk areas; many seasonal risk areas in South Africa had a lower incidence of (reported) malaria cases twenty or more years ago, and recent evidence suggests that the amount of people contracting malaria in seasonal risk areas in Southern Africa (e.g. Kruger) has increased of late - therefore, higher risk now than then; and, if anyone of you (especially the children) had been unlucky enough to contract malaria, your attitudes towards the disease would almost definitely have been different.

One final, and very important, point that needs to be made, and which is unequivocal, Renervr: you have declared yourselves to be medical professionals - specialists at that; remember that people then will look up to you as authorities on medical conditions and their treatments.

Quote:
I stand amazed at all the old wife tails and urban legends!?

Not quite sure what you mean by this? :huh: If you're saying that you "stand amazed at all the old wife tails (sic) and urban legends!?" because malaria is not a serious disease, then this would have no founding in research and fact! Many people contract malaria and/or die from the disease because their knowledge base is insufficient or they choose to be irresponsible in the face of the risks. This is no exaggeration either as millions of people do die from a combination of insufficient information, insufficient knowledge, insufficient caution, insufficient awareness, insufficient diagnosis, and insufficient treatment!

Quote:
With a bit of lateral thinking you ask the qeustion how many thousands if not hundreds of thousand babies live in the eastern areas with the mozies and the heat!Yes there are many malaria cases but once again the studies tell the storie that in 98% of cases not a single type of precaution used!

I'm not sure what areas you are referring to when you say the "eastern areas"? :huh: If you are talking about the eastern areas of South Africa, then yes, there is a relatively low risk of anyone, including babies, contracting malaria - relative to high risk areas like Mozambique or tropical Africa! Still, these facts mean that babies and adults alike nevertheless do get malaria - which may be increasing in infection-frequency and fatalities - and this does not warrant suggesting that the disease is not as serious as it is known to be! Every exposure to a mosquito in a malarial area is a potential risk of contracting malaria - for everybody!

Please do not make unfounded statements unless you have researched the topic sufficiently! Opinions are one thing, and personal clinical "evidence" another. However, malaria is not about opinions, but facts, and people's awareness of the serious, and often fatal, consequences of the disease must not be diluted by inaccurate observations and insufficient research and clinical evidence!



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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 Post subject: Re: Are we being stupid ?
Unread postPosted: Mon Nov 22, 2010 11:54 pm 
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Bundi wrote:
Think about it this way: Are there no babies being born and raised in any malaria areas around the world? What do they do?

To be blunt, they die.

WHO wrote:
Malaria is especially a serious problem in Africa, where one in every five (20%) childhood deaths is due to the effects of the disease. An African child has on average between 1.6 and 5.4 episodes of malaria fever each year. And every 30 seconds a child dies from malaria

Source: www.who.int/features/factfiles/malaria/en/index.html

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 Post subject: Re: Are we being stupid ?
Unread postPosted: Fri Nov 26, 2010 4:59 pm 
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onewithnature wrote:
Bundi wrote:
When was the last time any infant or grown up passed away from malaria contracted in the Kruger?


There have been far too many people!! :cry: :cry: Have you heard of Bruce Bryden? I myself came across someone less than two months ago! Many, many more have been ill from malaria - even some families of forumites. Just ask around.

Take it in perspective - sure - but don't become one of the statistics through ignorance and unfounded bravado!!! :pray:

I just want to add on to what onewithnature comment. I do not have any first hand experience on malaria, but made use of media to gain knowledge. We also followed the same approach than Mrs P and it will not difficult to implement. There are lots of game reserves in malaria free area in KZN and Limpopo to visit if you stay in Gauteng. :D

I found the following attachment from allafrica.com quite interesting. :big_eyes: The area discussed is west of Kruger, which place nothern Kruger in the same risk area. Another point is that the government protects people by spraying their houses with pesticides in malaria epidemic areas, but I am not sure if Kruger practice the same during summer season. :roll: The news clip is from Jan 2010; the last rainy season I could get info on. This news article points out the real risk of malaria in Kruger, allthough not mention but all areas in the article borders on Kruger or is very close.

Malaria Cases Climb in Limpopo
Sydney Masinga
11 January 2010

Polokwane — More than 156 cases of malaria have been confirmed in the high-risk areas of Vhembe and Mopani in Limpopo during the first week of January 2010.
Spokesperson for the Limpopo Department of Health and Social Development Selby Makgotho said four deaths from malaria-related complications were also confirmed during the last week of December.
"To date, the province has recorded a total of 1 120 malaria cases since the beginning of the rainy season.
The majority of these cases were reported in known malaria-risk areas in Limpopo, namely the northeastern parts of the Vhembe district and the eastern parts of Mopani, which includes Giyani and Ba-Phalaborwa," said Makgotho.
He added that although a higher number of cases had been reported over the past two weeks, it had not reached epidemic levels.
"But the department views the increase in a serious light and all efforts are being made to contain it and adequately deal with those patients already infected with the malaria parasite. Systems are also in place to monitor the reported cases on a daily basis and to respond to further increases," he said.
Makgotho advised Limpopo residents to seek medical attention as soon as they suspected they had malaria.
"It should be noted that malaria, when diagnosed in time, can be treated and cured fully. For this reason, we continue to urge communities to immediately consult their nearest health facilities for malaria tests if they experience flu-like symptoms such as body pains, headaches and fever," Makgotho said.
He said the department had 42 malaria teams in the province which were busy with a malaria indoor residual spraying campaign.
"This campaign, which is one of the major malaria control interventions in the province, aims to spray all the inside walls of houses in high-risk areas to contain the spread and transmission of malaria," said Makgotho.
The teams have completed the spraying of more than 680 000 houses during the current spraying campaign, which started in September 2009.
http://www.Allafrica.com" onclick="window.open(this.href);return false;" onclick="window.open(this.href);return false;

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 Post subject: Re: Are we being stupid ?
Unread postPosted: Fri Nov 26, 2010 9:03 pm 
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Bundi wrote:

Let me rephrase by saying this: When was the last time any infant or grown up passed away from malaria contracted in the Kruger?

Have a read of the posts by Wildtuinman in this thread, especially about the one where he had both his wife and infant daughter in intensive care at the same time. Then go and read the last few posts in this very thread, where 'mites are sending best wishes to a member's mother after she recently contracted malaria in Kruger.
Bundi wrote:
My point is that too much are being made from contracting malaria in Kruger,

I think what we are trying to do is point out that there is a risk of malaria and point out the options and precautions to take
Bundi wrote:
but I am not discarding the fact that it is a threat and I wish everybody a safe December holidays.

And the same to you, have a [safe] holiday. :lol: :lol:

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 Post subject: Re: Are we being stupid ?
Unread postPosted: Mon Nov 29, 2010 11:58 am 
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Hi Bundi

Yes, NON-DRUG ANTIMALARIAL MEASURES (antimalarial and anti-insect sprays, netting, mosquito and insect mats, UV-lights, burning repellant coils, etc.) are essential in preventing contraction of the dreaded disease that kills hundreds of thousands of people every year. Malaria is not a joke and I see that you are one of the few who understand its consequences!

Yes, the risk of malaria in Southern Africa [excluding areas such as Mozambique; parts of northern Zimbabwe; and possibly northern Botswana and the Caprivi Strip, as these areas are high risk)] as compared to, for example, Central Africa and other areas south of the Sahara that are in the Tropics, is very much lower! Most of the population of South Africa live in non-malarial areas. So, indeed, the risk in seasonal risk areas, is mostly low.

However, I believe that, as most people fail to take adequate non-drug measure prevention, and many more fail to take chemoprophylaxis (antimalarial drugs) when it is recommended, it is far safer to not tell people that the risk is low. The last thing we want is for people contracting malaria when it was easily preventable! Based on this, I always err on the side of caution and recommend the best prophylaxis (including chemoprophylaxis when it is suggested by the authorities) for an area. Most people are indeed ignorant of the risk and consequences of malaria, so this route is the wisest!

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 Post subject: Re: Are we being stupid ?
Unread postPosted: Mon Nov 29, 2010 5:02 pm 
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I have been following this topic with a lot of interest. many different view points coming across.

In my opinion I feel that every parent should simply ask the question;

If we take every possible precaution and my child contracts malaria and dies - can I live with myself?


Even if the odds are one in a billion chance of contracting malaria - what if your child is that one in a billion?

We all take precautions against accidents - but they still happen -
We all take precautions to protect our homes - there are still break ins,violence and murder

Just my thoughts on the subject.

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 Post subject: Re: Are we being stupid ?
Unread postPosted: Mon Nov 29, 2010 9:00 pm 
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I think the last couple of posts is getting us much closer to the right awnser.Yes malaria is real in kruger and if you are not comfortable dont put your children at risk and stay clear.If like me you feel you are just as safe in the park than any otherplace in south africa then go and do all you can to protect your children and yourself.You cant always run from everything in life

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 Post subject: Re: Are we being stupid ?
Unread postPosted: Tue Nov 30, 2010 2:07 pm 
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A heated topic indeed! :redface:

So let me jump in here too. Being a medical professional - and travel health advisor - I have had this discussion over and over with people. To keep it simple:

1. KNP is a high risk malaria area during Sept through to May. ANTIMALARIAL CHEMOPROPHYLAXIS IS ADVISED DURING THIS PERIOD. Together with non-drug measures - which are applicable throughout the year.

This is a fact. It has not been thumb-sucked by someone - it is scientifically based. (And determined looking at the risk of contracting malaria at that time in that area vs the risk of serious side effects from the antimalarial drugs)

Take the advise or leave it - but at least make the decision knowing the facts. If you then decide not to take antimalarials and you do get malaria - it was because of your decision, and not because you were misinformed.

It is the same as taking any other precautionary measure - taking blood pressure tablets if you have high blood pressure, or wearing a seatbelt if you're in a car. Nobody forces you to do it. It's just common sense to use precautions if they are available to decrease your risk...


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 Post subject: Re: Are we being stupid ?
Unread postPosted: Tue Jun 19, 2012 3:07 pm 
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There are indeed very brave parents in this country.

For me personally, not almost worth the risk to be selfish to go on a Kruger holiday and risk losing my most precious belonging. Never in a million years.

MALARIA kills more children in Africa than anything else!

Furthermore. The difference between getting in to a car and going to a mall and having to go to Kruger is plain and simple. You do not have to go to Kruger. Yes, unfortunately you have to drive and go out and buy food and other necessities. So the comparisons some are making here are not in the least valid.

Will you dress your child in a bulletproof vest and send him/her out to go pat a lion? Now why on earth would you introduce an under 5 year old to the most deadliest decease EVER in Africa? Doesn't make any sense.

Waiting for 5 years for your child to be old enough to visit Kruger is a very small price to pay before having to bury a young child.

I guess in having lost my mom, two brothers and now having a very ill dad just taught me to guard the life of a loved one as best as possible. You never know what you missing before it is too late.

Never ever think or say that it won't happen to you.

Crazy stuff. :doh:

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 Post subject: Re: Are we being stupid ?
Unread postPosted: Tue Jun 19, 2012 3:27 pm 
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Quote:
According to the National Institute of Communicable Diseases, 3 470 cases have been reported in South Africa in the 2011 malaria season.

Sixty-one percent were reported in Limpopo, 27% in Mpumalanga and the rest in KwaZulu-Natal.

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 Post subject: Re: Are we being stupid ?
Unread postPosted: Tue Jun 19, 2012 4:14 pm 
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wildtuinman,

I'm not arguing your statistics, or the sources you've obtained them from. I think this argument has gone in circles too many times to labour on any further.

I commented on this topic to wish gavinp well, as he's made a decision to follow his gut and push on. I was in the same predicament last year and made the same decision. Never looked back! I think it's fantastic! Well done gavinp!

I didn't at all say it "won't happen to me", but I trust it won't happen to me, and similarly trust it won't happen to him, or anyone else for that matter.

Best wishes to your ill dad. I trust all will go well.

*G


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 Post subject: Re: Any children activities in camps?
Unread postPosted: Sun Sep 02, 2012 2:52 pm 
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Hi Wilddog :D

Some camps are more child friendly than others.

All of the big camps have swimming pools. This is welcome for children, old and young, especially in the summer heat.

Skukuza and Satara day centres have lovely play areas for children where they can stretch their legs. I find Skukuza probably the most child friendly camp. Pretorius Kop also has a wonderful swimmng pool area for big and small children with lots of shade.

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 Post subject: Re: New parents in the Kruger
Unread postPosted: Wed Oct 17, 2012 8:47 am 
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Welcome Schooms,

In 2008 i took my first child to KNP for the first time and she was 1 year old. we continued to visit the park until today and now she is 5 years old without contractiny any malaria but we were taking prophylaxis all of us including her. i can advise you to check with your paediatrician before visiting the park and get some insights about that.

Your experince of cnceiving a child in the park is similar to mine, now i have a second born child who is one month old and she was conceived at the Luxury Tents at Tamboti.

For now I have just suspended our visit in December due to our small baby but have planned to visit KNP next year once she is one year. our paediatrician advised us to inform him when visiting the park so he can prescribe something for us for prevention once the child is 1 year old.

Hope you can get some advises from other members.

Thanx


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 Post subject: 10 months old baby
Unread postPosted: Sun Nov 04, 2012 8:28 am 
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Is it too risky to take a 10 months old baby to kruger park in the summer time?? Are babies more at risk to malaria??


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 Post subject: Re: 10 months old baby
Unread postPosted: Sun Nov 04, 2012 8:34 am 
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Hi Johan_Otten and welcome to the forums :D

Summer is high risk time and Babies are high risk group. There is a lot of information on Malaria here on this thread. I have linked to the last page but you can go to the previous pages


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