Limpopo malaria risk area now includes Makhado

Louis Trichardt, previously excluded, now falls under the National Institute for Communicable Diseases (NICD)’s low risk area for contracting malaria, reports Polokwane Review.

The National Institute for Communicable Diseases (NICD) made some changes to the areas for contracting malaria on its risk areas map published in December. The areas have changed since the last map was released in 2013.

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The entire malaria risk area has spread further towards the centre of Limpopo, and large areas previously deemed no risk areas are now at low risk, and some previously low-risk areas are now at moderate risk.

The NICD recommends using non-drug measures in low-risk areas at this time, such as mosquito nets and repellents. If people are travelling through moderate risk areas, they recommend the use of prophylactic medication, however, this must only be done on the advice of a medical practitioner.

The entire Vhembe District currently falls in a risk area. The NICD states that the borders of risk areas should be regarded as approximate, and that sporadic transmission may occur outside designated areas.

Many people have recently returned from holidays in high-risk areas and people are urged to be aware for four to six weeks after returning home after possible exposure, looking out for the onset of flu-like symptoms such as fever, headache, chills, or aches in muscles and the body. Should these or similar symptoms arise, they are urged to immediately see a medical practitioner to be tested for malaria.

Up to the end of October 2018, more than 16,000 cases of malaria were reported across South Africa and 110 deaths reported for the previous. There was an increase in malaria cases in 2017 after an annual average of 7,600 reported cases for the decade preceding.

Malaria is a life-threatening disease that is a major health risk for travellers to malaria-endemic areas. Appropriate advice and use of drugs and, most importantly, non-drug prophylactic measures can prevent most travellers from contracting the disease, however, no anti-malarial drug used for prophylaxis is 100% effective and compliance may be an issue. Special emphasis should always be placed on the importance of preventing contact with mosquitoes. Malaria mosquitoes mostly feed between dusk and dawn, indoors and outdoors.

Personal protection measures include:
• Remain indoors between dusk and dawn.
• Wear long-sleeved clothing, preferably light coloured, long trousers, and socks are recommended.
• Mosquito repellents applied to the exposed skin are highly effective. The most effective
compounds are those containing DEET (N,N-diethyl-3-methylbenzamide). These should be applied sparingly to exposed skin surfaces and ideally repeated after 4-6 hours and after showering or bathing. Repellents should not be applied to the face or lips or eyelids and the dosage should not be exceeded, especially for small children. Use repellents strictly according to manufacturers’ instructions.
•Knock-down insecticidal sprays, vaporisation mats, and mosquito coils are also highly effective and may temporarily eliminate mosquitoes that have gained entry to a dwelling. Spray inside the dwelling with an aerosol insecticide (for flying insects) at dusk, especially the bedrooms, after closing the windows.
•Use anti-mosquito gauze on windows and doors, particularly for residents of malaria areas. Ceiling fans and air conditioners are also effective in disturbing mosquito feeding. Bednets are useful in preventing mosquito bites. Nets should not be damaged and must be tucked in under the mattress. Baby cots and prams may be covered with mosquito netting for protection against mosquitoes.
•Before entering an endemic malaria area, the relative need for malaria tablets in addition to personal protection measures against mosquito bites needs to be determined. It is important to note that no prophylactic regimen is 100% effective.

Most persons presenting with malaria in South Africa either acquire the infection in malaria risk areas within the country, or have a history of travel to neighbouring countries, with the highest risk in Mozambique. Malaria risk areas within South Africa are the lowveld areas of Limpopo, Mpumalanga, and northern KwaZulu-Natal.

Any person who develops a fever, chills, headache, and muscle/joint pain within 10 to 30 days of returning from a malaria-endemic area must seek medical attention urgently and have a malaria blood test as soon as possible. Travellers must inform their health practitioners of recent travel. Medication to prevent malaria, while highly effective, may not be 100% protective.

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