How to Avoid Malaria When Traveling in Africa

Blood-Filled Mosquito

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Malaria is a parasitic disease that attacks red blood cells and is usually spread by the female Anopheles mosquito. Five different kinds of the malarial parasite are transferable to humans, of which P. falciparum is the most dangerous (especially for pregnant women and young children). According to a report published by the World Health Organization, malaria was responsible for the deaths of 445,000 people in 2016, with 91% of fatalities occurring in Africa. Of the 216 million malaria cases reported in the same year, 90% occurred in Africa.

Statistics like these prove that malaria is one of the continent's most deadly diseases - and as a visitor to Africa, you are also at risk. However, with the right precautions, the chances of contracting malaria can be reduced significantly. 

Pre-Trip Planning

Not all areas of Africa are affected by the disease, so the first step is to research your intended destination and find out whether or not malaria is an issue. For up-to-date information on malaria risk areas, check out the information listed on the Centers for Disease Control and Prevention website.

If the area that you're traveling to is a malaria area, make an appointment with your doctor or nearest travel clinic to talk about anti-malaria medication. There are several different types, all of which come in pill form and are prophylactics rather than vaccines. Try to see your doctor as far in advance as possible, as most clinics do not keep stocks of malaria prophylactics and may need time to order them for you. 

Unfortunately, it's unlikely that your health insurance will cover the prescription in the US. If cost is an issue, ask your doctor about generic pills rather than brand ones. These contain the same ingredients but are often available for a fraction of the price. 

Different Prophylactics

There are four commonly used anti-malaria prophylactics, all of which are listed below. The right one for you depends on a variety of different factors, including your destination, the activities you plan on undertaking there and your physical status or condition.

Each kind has its benefits, drawbacks and unique set of side effects. Young children and pregnant women need to be particularly careful when choosing malaria medication for this reason. Ask your doctor to advise you on the prophylactic that will best suit your specific needs. 

  • Malarone is one of the most expensive anti-malaria drugs, but only needs to be taken a day before entering a malaria area, and for one week after your return home. It has very few side effects and is available in a pediatric form for children; however, it must be taken daily and is unsafe for pregnant or breastfeeding women. 
  • Chloroquine is only taken weekly (which some travelers find more convenient) and is safe for use during pregnancy. However, it has to be taken for several weeks before and after your trip and may exacerbate certain existing medical conditions. In many areas of Africa, mosquitoes have become resistant to chloroquine, rendering it useless. 
  • Also taken on a daily basis, doxycycline only needs to be taken 1-2 days before traveling and is one of the most affordable anti-malaria medication options. However, it has to be taken for four weeks after your trip, is unsuitable for children and pregnant women, and can increase photosensitivity, rendering users susceptible to bad sunburn. 
  • Usually sold under the brand name Lariam, mefloquine is taken weekly and is safe for pregnant women. It is also relatively affordable but must be taken two weeks prior to and four weeks after travel. Many users complain of bad dreams whilst on mefloquine, and it is unsafe for those with seizure disorders or psychiatric conditions. Parasites may be resistant to mefloquine in some areas.

There are different instructions for each pill. Make sure to follow them carefully, taking particular note of how long before your trip you should start taking the medication, and for how long you must continue to take them after your return. 

Preventative Measures

Prophylactics are essential because it is impossible to avoid every single mosquito bite, no matter how diligent you are. However, it's a good idea to avoid bites wherever possible even if you are on medication, especially as there are other mosquito-borne diseases in Africa that are not covered by anti-malaria pills. 

Although most upmarket safari lodges provide mosquito nets, it's always a good idea to bring one with you. They're light and easy to fit into your luggage. Choose one impregnated with insect repellent, or spray yourself and your room every night before you go to sleep. Mosquito coils are also highly effective and burn for up to eight hours. 

Choose accommodation with fans and/ or air conditioning, as the movement of the air makes it difficult for mosquitoes to land and bite. Avoid wearing strong aftershave or perfume (thought to attract mosquitoes), and wear long pants and long-sleeved shirts at dawn and dusk when Anopheles mosquitoes are most active.

Symptoms and Treatment

Anti-malaria pills work by killing malaria parasites at an early stage of development. However, while they certainly reduce the risk of contracting malaria dramatically, none of the prophylactics listed above are 100% effective. Therefore, it is very important to recognize the symptoms of malaria, so that if you do contract it, you can seek treatment as quickly as possible. 

In the early stages, malaria symptoms are similar to those of the 'flu. They include aches and pains, fever, headaches, and nausea. Extreme chills and sweating follow, while infection by the P. falciparum parasite causes delirium, drowsiness, and confusion, all of which are symptomatic of cerebral malaria. This type of malaria is especially dangerous, and immediate medical attention is crucial. 

Some types of malaria (including those caused by P. falciparum, P. vivax, and P. ovale parasites) can recur at irregular intervals for several years after initial infection. However, malaria is usually 100% curable as long as you seek prompt treatment and complete your course of medication. Treatment involves prescription drugs, which depend on the type of malaria you have and where you contracted it. If you are heading somewhere particularly remote, it's a good idea to take the appropriate malaria cure with you. 

This article was updated by Jessica Macdonald

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