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Malaria

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ndloti
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Re: Malaria around Shingwedzi and further north.

Unread postby ndloti » Wed Jun 12, 2013 10:22 am

Posting your questions on this thread could also be usefull :

viewtopic.php?f=74&t=530&start=1230
KNP is sacred. I am opposed to the modernisation of Kruger and from the depths of my soul long for the Kruger of yesteryear! 1000+km on foot in KNP incl 56 wild trails.200+ nights in the wildernessndloti-indigenous name for serval.

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Re: Malaria around Shingwedzi and further north.

Unread postby garrow » Wed Jun 12, 2013 10:50 am

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

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Re: Malaria around Shingwedzi and further north.

Unread postby WeskusKlong » Wed Jun 12, 2013 11:05 am

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.
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Re: Malaria around Shingwedzi and further north.

Unread postby ndloti » Wed Jun 12, 2013 1:21 pm

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 .
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Re: Malaria around Shingwedzi and further north.

Unread postby Rooikat » Wed Jun 12, 2013 2:11 pm

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.
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Re: Malaria around Shingwedzi and further north.

Unread postby saraf » Wed Jun 12, 2013 5:21 pm

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.
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Re: Malaria around Shingwedzi and further north.

Unread postby WeskusKlong » Thu Jun 13, 2013 9:54 am

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.
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Re: Malaria around Shingwedzi and further north.

Unread postby Bush Baptist » Thu Jun 13, 2013 11:14 am

Thanks ndloti for the informative info. :thumbs_up:

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.
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Re: Malaria around Shingwedzi and further north.

Unread postby Bushbuddies » Thu Jun 13, 2013 12:04 pm

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.
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Re: Malaria around Shingwedzi and further north.

Unread postby WeskusKlong » Thu Jun 13, 2013 2:49 pm

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 :thumbs_up: .
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Re: Malaria around Shingwedzi and further north.

Unread postby yoda » Tue Jun 18, 2013 5:41 pm

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.

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Re: Malaria

Unread postby boertjie » Wed Jul 10, 2013 7:43 am

Sorry if this was asked before ...
Does anyone know the rate of malaria infections now 2000 compared to the 1970's and 80's ?
What is done today to stop the mozzies ?
Compared to the DDT of the 70's and 80's ?

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Re: Malaria

Unread postby Stephens.L » Wed Jul 10, 2013 11:14 am

The choice of malaria prophylaxis needs to be made in consultation with your doctor. The different drugs have different side effects, and a full history and examination will need to be performed to determine the drug that is best suited to the patient. Drugs that are effectively used as prophylaxis in the Kruger Park are Doxycycline, Mefloquine and Atovaquone-Proguanil.

The medical practitioners in the park are Dr Gary Peiser and Dr Ninette Muller who are based at Skukuza. The number for their surgery is 013 735 5638. You can also visit their website on http://www.krugerdoctors.co.za/.
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Re: Malaria around Shingwedzi and further north.

Unread postby onewithnature » Sun Jul 14, 2013 1:04 am

In this so-called information age, it is amazing how few people are actually informed. :hmz: (Then again, they also say that we live in a paperless society, but I'm sure the trees would not agree. :whistle: ) This applies to subjects accross the board, and malaria is certainly no exception. I think the problem is that there is just too much information out there and, sometimes, there are sites and people which offer substandard, and maybe even downright incorrect, information. The result is a melee of confusion which can lead to even educated, sensible people doing the wrong things. The basics of malaria prophylaxis are non-drug measures all year round in all malarial areas, with the recommended addition of chemoprophylaxis (antimalarial medications) in all high-risk areas (assuming, of course, that the traveller is medically able to use such medication or travel to a malarial area). The attribution of risk in any area can be deduced from competent malaria-risk-areas maps, and hence the traveller to such areas can make informed decisions in association with a competent health professional based on the risk in that area at that time of year and the susceptibility of the person to contracting malaria (which also includes a personal medical history and risk-factors assessment). Like Weskusklong's excellent metaphor, malaria prophylaxis can be likened to the necessary, but generally restrictive and/or uncomfortable, use of a seatbelt to minimise risk of death when involved in a close-encounter with it. However, that prevention should never be ignored, for it only takes one accident or one mosquito. Ndloti's understanding that the density of human population is related to malaria risk in malarial areas is correct, to a point: the number of people bitten by malaria-carrying mosquitoes increases the number of human vectors that can transmit the disease. However, malaria is a multifactorial disease and meteorological and other factors also affect the prevalence of mosquitoes at any given time. Perhaps then, to be too specific and detailed in predicting malaria risk over short time periods might entertain similar pitfalls of inaccuracy inherent in trying to be too specific with, for example, weather predictions - the number and variation of fluctuating factors (both malarial and human) is too complicated to generate an accurate model, and hence there is most probably value in maintaining conservative and acceptable guidelines, as is generally done by competent advisers. People will always have different attitudes to risk - some are sensible and some are maverick (perhaps this reflects the diversity of the human condition) - but it is essential that people make their decisions consciously knowing what the risks are, and then remain vigilant for any signs of malaria so that, if necessary, treatment can begin timeously. It must never be forgotten that malaria is a preventable disease and that there is no excuse for neglect.

Disclaimer: My recommendations here - though based on some experience and some drug 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.
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Re: Malaria

Unread postby JDW » Sun Jul 14, 2013 12:56 pm

The message is very simple -
GO AND SEE YOUR DOCTOR OR OTHER APPROPRIATE HEALTH CARE PROFESSIONAL WHILE INITIALLY PLANNING YOUR TRIP.
ACT ON THAT ADVICE.
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