Malaria is a parasitic disease most commonly spread by the female Anopheles mosquito. Five different kinds of malarial parasite are transferrable to humans, of which P. falciparum is the most dangerous. In 2015, malaria was responsible for the deaths of half a million people, with 90% of fatalities occurring in sub-Saharan Africa. It 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.
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 it is a malarial area. 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 of anti-malaria medication available, 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 specifically for you.
Unfortunately, it's unlikely that your health insurance will cover the prescription in the US.
If cost is an issue, ask you doctor about generic pills rather than brand ones. These contain the same ingredients, but are often available for a fraction of the brand price.
There are four commonly used anti-malaria medications, each 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 personal 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-malarial 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 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 travellers 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 some areas, 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 travelling 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.
Sometimes called 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. Some areas may be resistant to Mefloquine.
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.
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, which may attract mosquitoes; and wear long pants and long-sleeved shirts at dawn and dusk when Anopheles mosquitoes are most active.
Malaria Symtoms & 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 recognise the symptoms of malaria, so that if you do contract it, you can seek treatment as quickly as possible.
In the early stages, malarial 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 in particular can be fatal, and immediate medical attention is crucial.
Contrary to popular belief, not all types of malaria result in recurring episodes. Usually, malaria is 100% curable as long as you seek prompt treatment. 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.
- Anti-malaria prophylactics
- Insect repellent
- Mosquito net
- Long-sleeved clothing and trousers
This article was updated by Jessica Macdonald on September 1st 2016.