What to know for travel to Africa: Malaria prevention 101

The year of return 2019 is an initiative by Ghana to encourage African diasporans to settle and invest in Africa.

Ghana is a beautiful country with amazing people, culture, and delicious cuisine with lots to do and see. I have visited Ghana and enjoyed it very much.

It is important for tourists travelling to malaria-endemic areas to be aware and mindful of the prevention of malaria also called malaria prophylaxis.

Malaria is a tropical illness in rainy climates. The mosquito breeding areas tend to be in stagnant waters because, after the rain, the female anopheles mosquito lays her eggs in these waters.

Malaria is a febrile illness caused by an attack of the parasite, Plasmodium on the red blood cells.

The parasite plasmodium is transmitted through the bite of specifically the female anopheles mosquito. Upon entering the bloodstream, the parasite enters the liver of the person bitten, where it then develops and multiplies spreading its havoc to the body.

Malaria can present with fever 7 days after a mosquito bite. Other symptoms include chills, muscle ache, general weakness, bitter mouth taste, headache, vomiting, diarrhoea, cough or confusion. The illness of malaria can present with a varying range of severity from mild, moderate to severe.

Malaria is a serious condition of the destruction of red cells by this parasite. Invasion of the brain can lead to cerebral malaria characterized by serious illness with headaches and seizures, leading to coma and death. Other complications include serious hemolysis (breaking down of red cells) and renal failure.

Preventing malaria takes the form of prevention of the mosquito bites as well as medication to eliminate the plasmodium parasite in the red cells as a prevention strategy. Treatment of malaria requires a different pathway of care and is not covered in this post.

Photo by Ayooluwa Isaiah on Unsplash

Prevention of Mosquito bites:

Sleeping under mosquito nets. Incesticide-treated nets work better than plain nets.

Ensuring indoor rooms are sprayed with insecticides. Read the instructions for safe use of insecticide sprays.

Wearing light coloured clothing, white or khaki after dusk.

Wearing long sleeve and long trousers that cover your arms and legs.

Mosquitoes come out after 5 pm, so try to keep activities indoors after this time if possible.

Apply insect repellant to exposed skin Eg. DEET or natural repellant sprays or lotion/creams.

Medications for Malaria prevention:

This is written for general education purposes, not for diagnosis or treatment. Anyone preparing for travel to a malarial zone is well advised to see their doctor or travel clinic for advice on medications to prevent malaria.

Doxycycline, 100 mg taken every day started 1 to 2 days before travel, during and 4 weeks after travel. Doxycycline can cause photosensitivity and not for use in children under 8 years or pregnant women due to permanent irreversible teeth staining and other undesirable side effects. Doxycycline has an additional benefit in preventing minor diarrheal illnesses because of its antibiotic activity.

Mefloquine (Lariam): one tablet is taken weekly, started one week before travel, and weekly on the same day of the week during the visit to the malarial zone and for 4 weeks after return. This is very good for people who do not like taking daily pills. Important to note that Mefloquine may have some insomnia side effects and neuropsychiatric symptoms, so may not be tolerated.

Atovaquone/proguanil (Malarone): one tablet is taken daily. Start 1 to 2 days before travel, continue during the visit to the malarial area and for 7 days after leaving the malarial area.

Safe travels and enjoy your African travel experience.

Written by Dr. Ngozi Onuoha

Also read: About yellow fever https://health4naija.com/what-is-yellow-fever/

Resources:

https://ncdc.gov.ng/diseases/info/M

https://www.cdc.gov/malaria/travelers/index.html

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