KRUGER NATIONAL PARK IS A HIGH RISK MALARIA AREA FROM OCTOBER TO MAY.
It is a well-known fact that malaria is one of the most serious and common tropical diseases in the world. However, there is no reason why this disease should deter you from coming to the Kruger National Park if the necessary precautions are taken.
The information provided here from the Kruger National Park Malaria Information Centre (South African Parks Board) will make your visit to Kruger National a safe and rewarding one.
PROPHYLACTIC MEASURES TO PREVENT MALARIA
It is most important to note that no preventative measures are 100% safe. Should flu-like symptoms and signs of malaria like body pain, headache and fever develop 7 to 20 days or longer after visiting a malaria area, daily testing for malaria should be performed until you are better or another definite diagnosis is made.
MALARIA CAN BE PREVENTED IN THE FOLLOWING WAYS
The most important and most effective way of preventing malaria is firstly to prevent mosquito bites. The following preventative measures can be taken:- Remain indoors from dusk to dawn if possible as malaria mosquitoes usually feed in the early evenings and mornings.
- Cover your arms and legs towards evenings with light coloured clothing to cover exposed skin areas and especially the ankles. Wear long sleeved shirts, long trousers, socks and closed shoes.
- Apply insect repellents to exposed skin areas every 4-6 hours.
- Burn insecticide coils or electrically heated insecticide tablets in the bedroom at night.
- Spray knock-down insecticide for flying insects inside the bedroom in the early evening with windows/doors closed if there are no window screens.
- Screened mosquito proof windows and doors and mosquito nets guard against mosquito bites.
- Clothes and nets impregnated with Pyrethroid could be used
- Take additional preventative drugs when visiting an endemic malaria area, especially in the warm and rainy months from October to May.
MEDICATION
The preventative medication of choice for visitors to the Kruger National Park and surrounding areas is a combination of CHLOROQUIN and PALUDRINE. Chloroquin is taken on a weekly basis and Paludrine daily. The first dose of Chloroquine should be taken a week before entering a malaria area to see if there are no serious side effects.
Paludrine can be taken 2 days before entering the malaria area. It is important to continue to take the medication during your stay AND FOR FOUR WEEKS after leaving the malaria area. It is advisable to take the medication at night with food to reduce side effects like nausea.
MEFLOQUIN is an alternative to the Chloroquin / Paludrine combination and it is the drug of choice when visiting other areas such as Zimbabwe and Mozambique if there are no contraindications for using Mefloquin. If the Chloroquine/Paludrine combination or Mefloquin cannot be used.
DOXYCYCLINE on a once daily basis can be taken after meals as a preventative drug. Please contact your general practitioner or chemist for the correct dosage according to age and weight. Discuss if any of the medications are contraindicated (i.e., in infants, young children, pregnancy, patients with psoriasis, porphyria or epilepsy).MALARIA IN PREGNANCY, INFANTS, SMALL CHILDREN AND OTHER SPECIAL CASES
Despite the fact that the South African National Department of Health recommends that pregnant women should preferably not visit a malaria area, many pregnant women do visit a malaria area and even live in the Kruger National Park. Extra care for preventing mosquito bites should be taken as malaria in pregnancy holds an increase in risk for both mother and child.
It is safe to use Chloroquin and Paludrine in pregnancy, even in the first three months of pregnancy. Mefloquin and Doxycycline must not be used in pregnancy. Because malaria has a faster and harsher effect in infants and small children, extra care should be taken to prevent mosquito bites.
Take Chloroquin syrup weekly and Paludrine tablets daily in dosages according to age and weight - the appropriate dosage can be obtained from your general practitioner or chemist. Drug transfer in breast milk is insignificant and infants require full preventative medication.
It is important to take the medication during and for four weeks after leaving the malaria area. The following people should, if possible avoid visiting malaria areas - or take extra care in preventing mosquito bites:
- Cancer patients on chemotherapy
- Persons on long term steroid therapy
- Persons whose spleen has been removed
- Persons with full blown aids - it is not contraindicated for an HIV positive person to visit a malaria area.
- People suffering from porphyria must not use Doxycycline. In this case, the combination of Chloroquin and Paludrine is probably safe to use. The safety of Mefloquin in porphyria has not been established.
- People with epilepsy should take care when using Chloroquin. Mefloquin is contraindicated in epilepsy.
- Pilots and mountaineers should not take Mefloquin as it could impair balance.
