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Malaria

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wildtuinman
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Re: World Malaria Day

Unread post by wildtuinman » Wed Apr 25, 2012 2:09 pm

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wildtuinman
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Re: World Malaria Day

Unread post by wildtuinman » Wed Apr 25, 2012 2:13 pm

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Re: Malaria - Kruger Fatalities

Unread post by Duke Ellieton » Wed Apr 25, 2012 3:22 pm

Hi WTM, today is World Malaria day and heard earlier on the radio that in SA the number of fatalities have dropped from 30000 per annum 10 years ago to about a 1000 now.

Don't know anybody who died from the disease after picking it up in KNP.

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Re: Malaria - Kruger Fatalities

Unread post by francoisd » Mon Apr 30, 2012 11:31 am

wildtuinman wrote:Up north at the Pafuri Picnic Spot there is a bench overlooking the Levuvuh river. On the bench is a little memorial plate for a lady named Heather Zietsman. I don't know the full details but from what I could gather she passed away after contracting malaria. A grim reminder to all who visits Pafuri.

Do you know of someone who have fallen victim to this decease after contracting it in Kruger?

I personally know of quite few people who have picked up malaria in Kruger but who were fortunate to live to tell the tale.

Did she actually contracted malaria at Pafuri or was the memorial bench as so many others just placed in one of her most favourite spots in Kruger?

Ones risk of contracting malaria inside of Kruger is much lower than contracting it in any of the directly bordering towns. One has to remember that the "malaria risk" of an area is based on the number of confirmed cases in a area that may span many towns and not necessary a geographical area such as for example Kruger NP.

Below a link to an scientific article titled "Risk of malaria in visitors to the Kruger National Park, South Africa"

This is a 1996 study performed in April which historically is the month with the greatest number of reported malaria cases in South Africa. 1996 according to the article was also the time of the most extensive malaria outbreak in the area in 10 years (average 70% more cases than the 2 preceding years). Having done questionnaire surveys for scientific articles before the response rate in this survey was very good and even above the norm.

The article presents some interesting findings such as:
1) 4.5 out of 10 000 visitors contracted malaria (one unconfirmed case included) = 0.05%

2) Of these:
2.1) 3 stayed in bungalows and 2 in campsite (not statistically significant)
2.2) 3 used prophylaxis and 2 did not (not statistically significant)
2.3) 2 visited other high risk malaria areas before or after Kruger (1 Mozambique, 1 Comoros)

3) Additional preventative measures did not statistical significantly reduced the attack rate

One can also contract malaria in a malaria free area as the February 2012 outbreak in the Tshwane district proves. If you have an infected human and female Anopheles mosquito in the same area there will always be a risk of malaria transmission.

Does all this mean you do not need to be vigilant? Definitely no, but be aware you may run a greater risk of contacting malaria while buying bread in White River that in a rest camp in Kruger due to the greater concentration of possible infected human host in town than in Kruger.
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Re: Malaria - Kruger Fatalities

Unread post by Scottm » Wed May 02, 2012 6:47 pm

Interesting view, Francois, and certainly food for thought. I have been through various phases taking and not taking the various medications that are available, and am now of the opinion that it is better (for us as a family) to avoid the medication and to keep aware of ALL health issues for quite some time after leaving the malaria areas. Having said that, we ALWAYS cover ourselves in the early morning and in the evenings with appropriate clothing (long trousers, sleeves, socks and closed shoes) and use a healthy dose of tabard on any exposed areas......

There are many views, both for and against taking anti-malaria medication, some of which include complaints of the side-effects of such medication to some people; the fact that IF you forget to take the medication exactly as per the instructions, you may as well not take it at all, and a whole host of other issues, such as the medication masking the onset of the disease.

It should be noted that taking anti-malaria does not GUARANTEE protection from the disease, but it may reduce the likelihood of catching it.....

As a side comment, a physician friend of mine says he prefers his patients to take malaria medication as without taking it, he knows exactly what to put on the death certificate.... :big_eyes:

I know many, many people that have had the disease, acquired in various parts of Africa, one of whom passed away within 72 hours of getting into a malaria area..... be aware that this is NOT a pleasant disease with which to deal, and is NOT NECESSARILY SLOW in its devastating effect.
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Re: Malaria - Kruger Fatalities

Unread post by Meandering Mouse » Wed May 02, 2012 7:10 pm

I have been reading Harry wolhuter's, "Memories of a Game Ranger", again.

He talks of a time when people did not know about the mozzie threat. It was a time when Maleria was the, "silent demon in the night". Maleria was endemic and struck when it wanted.

Lydenburg, place of mourning, is a testament to maleria. It killed, and killed with no regard for anyone.

Times have changed.

I am not dismissive of maleria, I recognise the danger. Bruce Brydon, many years a game ranger, ended up being killed by maleria.

However, we know more, we can do more. We do no longer need to be ruled by fear. We can do something.
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Re: Malaria - Kruger Fatalities

Unread post by francoisd » Wed May 02, 2012 7:18 pm

And as the research article I posted a link for states those people mentioned by MM ran I much higher risk that a tourist of contracting malaria in Kruger as they were resident. The same with residents of the neighboring towns. The longer time you spend in an area the greater the risk.
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Re: Malaria - Kruger Fatalities

Unread post by Meandering Mouse » Wed May 02, 2012 7:43 pm

Franscoisd,

I do think that we have to be aware of the control we have. We also need to take resposibility.

I am not the best example of anti-malerial medication. It does not agree with me and would ruin my few days of "Kruger joy". On one brand I get paranoid, and on another brand, I simply vomit.

However, after my last trip, even though I was 95% sure I had flu, I presented myself to be tested for maleria. We can take control.
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Re: Malaria

Unread post by Waterbuck » Wed May 16, 2012 6:16 pm

Hi there all. I am sure this has been asked a hundred times before, but I am not going to read 81 pages of this topic to find the answer :whistle: :whistle: ..............

I have been to Kruger often and have always taken precautions against being bitten and sometimes even malaria tablets (especially in summer). Now, with a trip coming up in the dead of winter (late June) I have a family row on my hands. I'll be taking my elderly parents and my kids to Kruger. Our GP has advised that we should not worry about malaria tablets for Kruger in the dead of winter, provided we take the necessary precautions against being bitten. Half the family is in agreement and the other half are probably blowing down my car types right now as an aftermath to the argument. Some solid advise would be greatly appreciated.................

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Re: Malaria

Unread post by saraf » Wed May 16, 2012 7:56 pm

I sympathise, I always have to fight my SO over malaria precautions as well.

I always say that you need to get your medical practitioner's opinion, looks like doing it has inflamed opinion. Get your parents to see their GP, everyone's medical history is different, malaria is not a one solution suits all, for example, my SO and I have to have different kinds.

I would say though that in the UK it would be difficult to get malaria tablets without a prescription from the GP. If mine said I didn't need them it would be difficult to get them.
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Re: Malaria

Unread post by DinkyBird » Wed May 16, 2012 8:19 pm

Waterbuck, this is my own personal opinion. I do not think you stand much of a chance contracting malaria in the winter. We go to KNP so often, we never take meds. BUT!

You can try as hard as you like not to get bitten, there is always a small chance you will be bitten. It happens to me. Everytime.

If you are not visiting the park often, rather be safe than sorry. Get Malarone = least side effects imo and experience. You need a prescription and it is expensive.

There is nothing like returning from KNP and worrying if you might have contracted malaria. Especially with kiddies. Save some sleepless nights :wink:
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Re: Malaria

Unread post by missings.a.! » Thu May 17, 2012 2:44 pm

Personally, aside from people who may have serious side effects,jmo it is best for the rest of us to take the meds, unless people visit so often they have built up immunity.

We can always do a test run before the trip to see if the meds disagree, but really, malaria is no joke and it is so easy to be bitten. Even before or after a shower or swimming.

We are so fortunate that we have access to these prophylactics and there are millions who live in malaria areas who contract it every year and many die.

From the WHO website

According to the World malaria report 2011, there were about 216 million cases of malaria (with an uncertainty range of 149 million to 274 million) and an estimated 655 000 deaths in 2010 (with an uncertainty range of 537 000 to 907 000). Malaria mortality rates have fallen by more than 25% globally since 2000, and by 33% in the WHO African Region. Most deaths occur among children living in Africa where a child dies every minute from malaria.

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Re: Malaria

Unread post by onewithnature » Fri May 18, 2012 9:05 am

Waterbuck, you don't say how old your children are (it is never recommended that very young children visit any malarial areas, even low risk; however, many people do take infants and believe that antimalarial measures will be sufficient).

Now, if your tyres are flat, I don't think you'll have to worry about malaria in Kruger. :twisted: But, seriously, the dead of winter (I suppose you mean July/August?; and "dead" isn't a good word to use when talking about malaria :tongue: ) means that Kruger is a low-risk area. The official recommendations, therefore, are that non-drug measures (antimalarial sprays, netting, coils, etc.) are sufficient, as long as they are applied, and reapplied as needed, from about an hour before dusk until an hour after sunrise.

I personally only use non-drug measures in low-risk season as the side-effects and/or expense of antimalarial chemoprophylaxis outweighs the risk of me contracting malaria. Of course, if you want to be super-safe, then by all means take chemoprophylaxis, but ensure that non-drug measures are also given suitable attention. Some people take meds all the time, while some people are quite okay with the official recommendations. The choice lies with each person.

Some people believe that adding sufficient quantities of ingested garlic to their non-drug measure arsenal helps to keep mossies away from their bite-sites on the skin. At the very least, it should keep your warring family members away from you so that you can enjoy the trip in peace! :twisted:

According to official sources, people do not build up immunity in a seasonal-risk malarial area; only in all-year-round high-risk malarial areas, if they live there permanently.

Whatever you decide, make sure that you have peace of mind so that you can enjoy your trip to the full, without worrying unnecessarily about contracting malaria. Then, still be vigilant after returning from the malarial area - any flu-like symptoms or unexplained illness, especially within two or three months (and some say even up till six months) after exiting the malarial area should be checked to see that it isn't malaria - falciparum malaria can be fatal, the strain that predominates in South Africa.
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Re: Malaria risk in August/September

Unread post by Blackmamba » Thu Jul 26, 2012 7:57 am

Kruger is my home away from home, its my happy place and my most favourite place on earth.
I have been going for about 30 years.
I'm quite a stickler for rules and doing things the right way, when I started taking my kids I made sure we NEVER went without our tablets, 1 week before, 4 weeks after, never missing one.
I sprayed us with repellent morning, noon and night, instead of sunblock you got a nice cream of Tabard, we slept under our permanent (treated mosquito nets) etc etc.
We never got Malaria, but I think what I got from taking those horrific tablets is even worse.
In December while camping in Pretoriuskop, I started getting ill, really really ill, I would lose consciousness, I would be dizzy but dizzy to a degree that I couldn't hold my head up, I couldnt stay awake, I started having panic attacks, I ended up in hospital 3 times by March this year and eventually after having an MRI, CT scan, and EEG I was diagnosed with Epilepsy, I was having seizures every 1 - 5 minutes - EVERY Doc and Neurologist that I have been too has said the same thing - the malaria tablets "most likely" triggered this.
Obviously they wont say for sure but they have all said the same.
If anyone has every read the pharmaceutical leaflet inside a box of Mefliam or any of the other medications check out the SIDE EFFECTS.
My opinion now is rather take my chances with Malaria than take those tablets.
And to think I gave them to my kids!!!!!!!
I feel ill to think that they could have suffered what I have suffered.
THANK GOODNESS IT HAPPENED TO ME AND NOT TO THEM.
CANT WAIT TO GO AGAIN!!!

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Re: Malaria risk in August/September

Unread post by onewithnature » Thu Jul 26, 2012 8:54 am

Thank you for your post, Blackmamba. Some of the antimalarials are contra-indicated, or should be used with caution, in people who have epilepsy, but I have never heard that antimalarials can cause epilepsy. I have pm'ed you, BM, so we could discuss this further.

I do not agree that most people should take their chances with malaria over the side-effects of the antimalarials. There are indeed some people where antimalarials should not be used, or used with calculated caution, but then a thorough assessment plus adequate alternative professional advice for them is essential; however, these people would constitute by far the minority of the population. Many times, the side-effects for the average person are transient or simply an annoyance rather than a reason to discontinue the drugs; if more severe, then there are often alternative drugs that can be attempted.

Malaria and its risks is not something that people should take lightly or be complacent about! The Falciparum strain of malaria that is prevalent in most of Africa (and many other countries of the world too) can be lethal if not diagnosed early enough and treated aggressively with the correct regimens. The reason that people mostly die from Falciparum malaria is because it moves into the brain - called cerebral malaria - and at that stage it is a very serious disease.

The correct principles to follow are to consult knowledgeable medical professionals and to weigh up the risks of contracting malaria in a particular area at a certain time of the year versus the potential (or actual) side-effects of taking antimalarial drugs. Then, taking into account other significant factors, including diseases that the person may have, a thorough recommendation as to which antimalarial to use should be made. As mentioned earlier, for those where it is felt that antimalarials should not be taken, the risks of entering the malarial area must be comprehensively explained and all preventative measures put into place so that the risk is minimised. Of course, in some circumstances, it may be appropriate not to enter the malarial area in the first place.

Malaria is no joke; never underestimate the damage it can do!



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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