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As a person in the medical field I can strongly advise you not to take a 10 month old to a malaria area in summer.
If babies contract malaria,their immune system is not fully developed and so they cannot fight it as well as adults do, the death rate is higher.
As a recent "new" mom I would hate to see my LO suffer what I have seen other babies suffer with malaria.
So if I may offer an opinion - visit malaria free areas until your child is older.....but it is your choice.

You have said it the best Scipio. Nobody should take chances, but I always wonder what about the babies that grow up in these regions. My 6 month old will in Dec go on her 3rd Kruger trip and my 3 year old will do her 13th I think.

I am well aware of the risks involved and we take serious precausions or rather preventative measures, which has always worked for us.

Kruger is not nearly as "dangerous" as it is made out to be and in my view is probably as "dangerous" as Nelspruit, but surely not in the same league as any other African state.

That is just my view and please do not base any decisions on what I am saying.

I often hear that pretoriuskop and berg en dal are lower risk malaria areas than say lower sabie, is this true ?
Also, those who know people that contracted malaria in Kruger, did these people take all precautions excluding prophylactics such as spraying peaceful sleep, indoors at dusk, net and buring candles?

Sybie, it has been said from time to time that some areas of Kruger are of lower malaria risk than others; it would be very difficult to prove this, as Kruger takes preventative measures in all regions as far as I am aware.
Remember, too, that your mentioned camps of Pretoriuskop and Berg en Dal are in higher rainfall areas, which may increase risk.
As malaria risk does, to some degree, depend on climatic and environmental factors, it is not always wise - and in my opinion, sometimes foolhardy - to try and justify certain areas within an officially designated malaria area as lower risk than others.
Better to be safer than sorry and take equal antimalarial precautions wherever in Kruger you may be.

Sybie, as to your second question, it would be very difficult to notate the habits of residents within malarial areas who have contracted the disease to see how much antimalarial non-drug measures they applied over time.
Additionally, people who live permanently in seasonal-risk malarial areas - like Kruger - are always at some risk, so these people can only lessen the risk by using non-drug measures.
If staying for a relatively short period, chemo-prophylaxis (drugs) can also be considered, but antimalarial drugs are not recommended for very long-term use anyway.
Which leaves non-drug preventative measures; and these may be logistically difficult to continuously and diligently adhere to = for example, the staff member may be frequently on the move at night (patrols, night-drives, camp managers, etc.), so might not easily be able to stay indoors as much as they needed to after dark.
Also, non-drug measures may be too expensive over long periods for those in lower-income groups.
So, though at face value the answer seems simple, there are many factors to consider.

If you read extensive personal advice which I have posted on other threads on the SANParks forum, you will see that I am in total agreement with these statements.

YES BRING YOUR INFANTS !! DESTROY MY AFTERNOON NAP WITH NAPPY CHANGING AND LOUD SCREAMING !! AND A STENCH OF A 1000 FARTS OR LEAKY SEWAGE DRAIN

i did not drive all the way from durban to be reminded that infants are mini-zombies.

i fail to understand how people can enjoy the holiday while the kid is between 0-8. you just cant, thats why me and the wifey havent had kids yet because we want to ENJOY peace and quiet (among other things ) in the kruger while we are young. (she's 22, me 25)



honestly, just stay at home, raise your kid and if he/she has manners and is 100% potty trained, doesnt need a leash then its all cool.

Thanks

Enjoy your holiday !


my opel 85" kadett now has 6 kruger stickers and 1 rhinoseday horn !

That is what democracy allows: everyone is entitled to an opinion. From a malaria standpoint, it is always wiser not to take the children until they are at an age where their risk of contracting malaria has become similar to an adult's and they wouldn't have debilitating adverse effects from antimalarial (and other) medicines. Also, some areas are very humid and hot, and a child may just not be comfortable in such ambient conditions.

However, as to the presence of a child on a holiday, I have to say that I have, and have always had, absolutely no qualms about encouraging my daughter to enjoy whatever and wherever we are (if it's age and morally appropriate). And, I have enjoyed every single stage of my daughter's development! People often complain about the "Terrible Two's" or the "Impossible Teens", or whatever, but I have never found this to be true: it's ALL about how one views a situation and what one's attitude to that situation is! I have been blessed by being given a magnificent daughter and I have thrilled to teach and encourage her through myriads of situations; she has developed a great love and respect for nature and animals; has respect for others and herself; is well-mannered; has a supreme sense of humour and keen eye for dissecting situations; is wise beyond her years; and generally is a great joy in our lives! If I hadn't suggested, and sometimes insisted, she come with us on holiday or day-trips, she might have been a recluse, focused only on video games, TV, cellphones, or the like. We have allowed her to enjoy the bounty of the world in so many ways, and I see that it has benefited her immensely.

Yes, sometimes other people's children can be noisy and intrusive, but I have learned to focus my mind elsewhere and, if really necessary, either say something to the parents or report it to the duty manager (which I have only done once). I think back to when I was little and how much fun we had by sprinting everywhere and making up games to keep ourselves entertained. Children are children, and should be encouraged, within social ambits, to be just that; too many children these days grow up too quickly and fail to enjoy a magical childhood.

As for nappy-changing, disgorging of stomach contents, and infant odours, it has never worried me: children survive the best they know and it is our privilege to help them to do so. All I have ever seen are the blessings that a child bestows on a parent. I can only imagine if my parents did not do the same for me, what I would have turned out to be; or even whether I would be on this earth. For we forget that WE were also infants, toddlers, and teenagers - smelly, noisy, contrary, challenging!!

Supertrooper, we shall await the birth of your first when it happens (GOD-willing), and then we will hear if your song has become more dulcet.

OWN


Well, well, well Supertrooper - you certainly do have an attitude.

I await the day you and your wifey have your first little Supertropper - I think you in for quite a little surprise and a big change in your attitude.

Nuf said .........

Supertrooper, an afternoon nap at 25, eish, you sure you are not 75... And if you once have children of your own, well, may the good lord protect them. Then again, with a wifey of 22, if you need help to keep the kids rustig, I will keep her company anytime while yo change the nappies..... now how do I do smilies on the mobile sit, maybe I should ask my little daughter, that would have never posted such an unthougjtfull post.

Well said OWN. The truth is out.

I think ST is in for a BIG surprise when the first infant arrives. He/she will be gaga over the child when it is there and marvel as it grows over the years.

A must read post and document, for anyone seriously trying to understand the risks. But not negating the additional professional advice you should always seek.

Anyhow some question(s) if I may:
The DOH pamphlet seems to confuse its information regarding 5-year old children. On the one hand at page 17 it suggests not taking them to a "malaria area" at all; whereas on page 25 it suggests not to take a child to a high risk area.
In neither case is it clear to me whether or not prophylaxis is covered or not (the pamphlet merrily notes certain drugs are dispensible to kids under 5). So:
1. Is there any point giving prophylaxis to a 4 year-old? (ie. Does it reduce risk - in the sense of helping a 4 year-old unlucky enough to contract malaria after taking the drugs)

So two more questions:
2. Is KNP considered a "malaria area" in July (mid-winter so <10 degrees)?
3. Is KNP considered a "high risk area" in Summer (the pamphlet's map at page 27 suggests not)?

I guess its poorly written, or defensively written being a government document ... but I would be grateful if learned forumites could point me towards clearer answers to my 3 questions.

Z&M, I will answer your last two questions first.

Kruger National Park is considered a seasonal-risk malarial area; which means that the malarial risk is considered suitably low during the colder months (taken as June, July, August, and September) that only correctly applied non-drug measures are suggested. In the warmer and wetter periods - defined for seasonal-risk areas in Southern Africa as October to May, inclusive - the recommendations are for both suitable non-drug measures plus appropriate antimalarial medications to be used in conjunction with each other.

However, remember that these are only generic, broad suggestions which, on the face of it, do not take into account people with special needs - such as young children, travellers that are immunocompromised, pregnant women, and so on. Therefore, each case should be reviewed according to its merits or demerits and a sound judgement made accordingly. Here is where consultation with a qualified and experienced health professional is greatly suggested. Several web-sites do give good information, but I have read some that give quite unsuitable, and sometimes downright ridiculous, advice; so make sure you consult someone that knows what they're talking about!

Some people have asked if Kruger is less high-risk than other high-risk areas of the world. By and large - and if nothing has changed in recent years - Kruger has mostly been diligent in spraying and controlling mosquito populations within its boundaries. Also, malaria risk is determined by other factors, such as amount of rainfall, timing of the rainfall, average daily temperatures, the lie of the land in promoting stagnant pools, and so forth. Also, malaria risk is often determined by the number of cases of people contracting malaria within a certain area. All of this together has prompted the authorities to say that Kruger is relatively lower risk than some other areas of the world, such as the malaria risk in Mozambique and large parts of Tropical Africa (consult suitable malaria-risk maps and accompanying information to glean more specific data related to this).

Nevertheless, it is best to follow pertinent and relevant advice for areas you are visiting so as to minimise contracting this dread disease. Kruger may be of lesser risk than some other parts of the world, but there is still a significant risk which should not be ignored. It is, I suppose, like comparing the risk of being knocked over on a busy road or a quieter road - just because the road is quieter doesn't mean that you shouldn't look when you cross!

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.

Z&M, as to your first statements and question, I have indeed wondered over certain seemingly disparate dollops of information for years; but I have finally, and tentatively, concluded that there are degrees of - not always absolute - advice when it comes to malaria. The reason for this is that people are also weighing up the risk of an individual contracting malaria in a risk area versus the benefits of going there in the first place.

The finest advice would be to completely ensure that a young child does not enter a malarial area at all, because, as has been mentioned previously, and as examples: (i) their immune systems may not yet be fully developed and so progression of the disease may be fatal quicker; (ii) it is not always easy to effectively and timeously diagnose malaria in a young child (they may not be able to effectively communicate their symptoms and how they're feeling; they may have other concurrent conditions/diseases whose symptoms and signs may approximate that of malaria; they, or their signs and symptoms, may only alert the parent to visit a doctor at a too-late stage; and so on); (iii) it may be more difficult to impress upon a child the need to stay indoors after dark and "hamstring" themselves with seemingly annoying non-drug measures.

Many parents feel the need to weigh up the options at their disposal and determine whether they will take the risk - however small or large - of exposing their children (and themselves) in a malarial area. I personally did not take my daughter to a malarial area until she was 8 years old as I know the dangers and was unwilling to expose her to them. Other parents will totally disagree with me. Each to his/her own.

Most official recommendations will suggest not taking children less than five years old to a malarial area - both high- and low-risk areas - as this is generally the best advice for them (as explained earlier). However, in the event that the child still goes to a malarial area (and particularly a high-risk one), then there are antimalarial drug options available to minimise that child's risk of contracting the disease. Not a perfect situation by any means, but at least the risk will be lowered. Of course, with medications comes potential side-effects that may hamper the child and/or cause serious distress. Again, these need to be considered in the final decision.

There are many factors to take into account to decide whether a young child (and of course any individual) is to enter a malarial area, but the bottom line is that as long as there is risk of contracting malaria, the person involved will be exposed to that risk, to a lesser or greater degree depending on what precautions are implemented to lower the risk.

Now, more specifically to you, Z&M, my recommendation for your 4-year-old is still the same; avoid malarial areas if you can. If you choose to take your child anyway, be very diligent in applying non-drug measures from just before sunset until just after sunrise. I would also consider adding antimalarial drugs (especially in high-risk season), but do this in conjunction with a well-recommended medical practitioner experienced in malaria prevention and treatment. Is it worth giving the drugs, you ask? Antimalarial drugs suitable for that patient, and given correctly and regularly, will almost certainly reduce the chances of the patient contracting and/or dying of malaria. However, this does not mean that the person will be fully protected, and hence the need still for non-drug measures with the antimalarial medication. And monitor the child for at least six weeks [and, more wisely, up to three (and some sites suggest six) months] after first entering the malarial area for any signs or symptoms that may indicate a malarial infection. If in doubt, check with a medical doctor!

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.