Malaria Alert

We are currently in the malaria season in Southern Africa. Malaria is of particular concern in returning travellers from high risk areas and who present with fever or flu-like illness. All medical practitioners should be on high alert when patients present with these symptoms and have a history of travel. High risk areas include certain lowveld areas of Mpumalanga and Limpopo, northern KwaZulu-Natal, and most importantly Mozambique, parts of Zimbabwe and other tropical African countries.

Prevention is better than cure, and travellers to these areas should be prescribed malaria prophylaxis, especially at this time of the year. The three recommended options, in addition to taking measures to prevent mosquito bites, are:

1.       Mefloquine:  Start at least a week before entering risk area, take once weekly while there and weekly for four weeks after returning. Adult dose 250mg weekly

2.       Doxycycline: Start at least one day before entering the risk area, take daily while there and daily for four weeks after returning. Adult dose 100mg daily.

3.       Atovaquone-proguanil: Start at least one day before entering the risk area, take daily while there and daily for seven days after returning. Adult dose 250mg/100mg

The choice will depend largely on patient factors, and must be strictly adhered to in order to ensure efficacy.