Malaria In Africa

Malaria in Africa is the most important disease hazard facing hunters. Malaria is widespread throughout most of Africa and is a serious and sometimes fatal disease.

For individual country maps go to: Malaria in African Hunting Countries

Malaria Facts

• Malaria is a parasitic disease spread by the bites of female Anopheles mosquitoes.
• Anopheles mosquitoes can be recognised by their 'head down' resting posture. Other types of mosquitoes hold their heads up in line with the body.
• The malaria parasite is called Plasmodium.
• 4 species of Plasmodium cause malaria in humans - Plasmodium Falciparum, Plasmodium Vivax, Plasmodium Ovale, Plasmodium Malariae.
• The parasites are in the mosquito saliva which is injected into the person to prevent the blood coagulating.
• The severity of the malaria disease is related to the number of parasites in the person's blood.
• Falciparum malaria is the most serious causing severe or even fatal consequences.

Malaria Symptoms

• The incubation period from the time of the bite to symptoms appearing is 5 to 10 days but may be up to even a year if anti-malarial drugs were taken.
• Principal symptoms are fever, chills with sweating, headache, abdominal pain and jaundice.
• Severe falciparum malaria causes symptoms associated with liver and kidney failure, anaemia, convulsions and coma.

Malaria Diagnosis

• As the early symptoms of malaria are pretty non-specific, be aware of the possibility of having malaria for at least a year after you return home from a malarial area.
• If you get any fevers or other vague symptoms, seek medical attention and a malaria test as soon as possible.

Malaria Testing Kits

• If you are going to be hunting or travelling in a very remote malarial area of Africa consider taking some malaria testing kits.
• They are small and simple to use. All the requirements (lance, reagent, sterile swab and indicator) are sealed in a sterile pouch. A pin prick of blood is mixed with a reagent and placed on an indicator strip rather like pregnancy testing. The result can be read after a few minutes.
• They can be purchased at most travel clinics or pharmacist shops.

Malaria Treatment

• Again, if you are going to a remote malarial area, discuss with your travel medicine expert or physician the merits of taking malarial treatment drugs.
• Coartem tablets (Artemeter and lumefantrine) can be used to treat uncomplicated falciparum and vivax malaria.
• Coartem is an intensive 3 day course of tablets with dosage dependent on body weight. Read the instructions carefully.
• Take a few boxes of Coartem in case you need to help others.

Malaria Prevention

You cannot be vaccinated against malaria in Africa or elsewhere, but you can protect yourself in 3 ways:

• Avoiding mosquito bites
• Taking anti-malarial drugs
• Getting prompt treatment if you suspect you or someone with you may have malaria

Avoiding Mosquito Bites

• Mosquitoes bite at any time of day but most bites occur in the evening.
• If you are out in the evening or night, wear long-sleeved clothing and long trousers.
• Mosquitoes may bite through thin clothing, so spray an insecticide or repellent on them. Insect repellents should also be used on exposed skin.
• Spraying insecticides in the room, burning pyrethroid coils and heating insecticide impregnated tablets all help to control mosquitoes
• If sleeping in an unscreened room, or out of doors, a mosquito net (which should be impregnated with insecticide) is a sensible precaution.
• Garlic, Vitamin B and ultrasound devices do not prevent mosquito bites.

Taking Anti-Malarial Drugs

• Start taking anti-malarial drugs before travel as guided by your travel health advisor. Some anti-malarials need to be started three weeks before arriving in a malarial area.
• Take the tablets absolutely regularly, preferably with or after a meal.
• It is extremely important to continue to take them for four weeks after you have returned, to cover the incubation period of the disease. Malarone is require to be taken for only 7 days post-travel.
• Make sure you use a drug which you can tolerate and one which is appropriate for your African destination(s).
• Be aware that no anti-malarial drug is 100% effective

Prompt Treatment

• There is no guarantee of complete protection from malaria in Africa.
• If you get a fever between one week after first exposure and up to one year after your return, you should seek medical attention and tell the doctor that you have been in a malaria area.

Common Anti-Malarial Drugs

Chloroquine

Brands: Avloclor, Nivaquine

• Consider a trial course before departure if using this regime for the first time. This is recommended to detect if you are likely to get side effects.
• Chloroquine should be started one week before exposure (to ensure adequate blood levels), throughout exposure and for 4 weeks afterwards.
• Nausea and sometimes diarrhoea can occur which may be reduced by taking tablets after food.
• Headache, rashes, skin itch, blurred distance vision (which may take up to 4 weeks to reverse) or hair loss may warrant changing to alternative drugs.
• Use with caution with liver and renal disease.
• Can aggravate psoriasis and very occasionally causes a convulsion so it should not normally be used in those with epilepsy.

Proguanil

Brand: Paludrine

• One or two doses should be taken before departure. It should be continued throughout exposure and for 4 weeks afterwards.
• Anorexia, nausea, diarrhoea and mouth ulcers can occur.
• Can delay the metabolism of the anticoagulant, warfarin, and result in bleeding. Those planning to take warfarin must discuss this with their doctor before starting any treatment.
• Use with caution with renal impairment.

Mefloquine

Brand: Lariam

• One dose should be taken a week before departure and it should be continued throughout exposure and for 4 weeks afterwards.
• Three doses at weekly intervals prior to departure are advised if the drug has not been used before - this can often detect, in advance, those likely to get side effects so that an alternative can be prescribed.
• Nausea, diarrhoea, dizziness, abdominal pain, rashes and pruritis can occur.
• Headache, dizziness, convulsions, sleep disturbances (insomnia, vivid dreams) and psychotic reactions such as depression have been reported. These reactions most commonly begin within 2-3 weeks of starting the drug and may be worse if alcohol is taken around the same time.
• Avoid in epilepsy or if there is a history of psychiatric illness.
• Exercise caution, and avoid if alternatives are available, in severe renal and liver failure and heart rhythm defects.
• Also caution in those taking digoxin, beta or calcium channel blockers when arrhythmias and bradycardia can occur.

Doxycycline

Brands: Vibramycin, Doxymal

• This is a broad-spectrum antibiotic of the tetracycline class used in the treatment of infections caused by bacteria and certain parasites.
• Can normally be used continuously for a period of at least 6 months.
• Consider a trial course before departure, if you are using this regime for the first time, to detect if you are likely to get side effects.
• Doxycycline need only be started just before exposure (2 days), continued through exposure and for 4 weeks afterwards.
• Sunburn due to sunlight sensitivity can occur. Use of sunscreens is especially important and if severe, alternative prophylaxis should be used.
• Heartburn is common so the capsule should be taken with a full glass of water and preferably while standing upright.
• It may reduce the effectiveness of the oral contraceptive pill.
• Taking the capsule in the evening should reduce the sun sensitivity during the day.
• It is a good idea to take daily acidophilus medication to minimise the risk of a candidal (thrush) infection which incidentally can affect men as well as women.
• Occasionally anorexia, nausea, diarrhoea, candida infection and sore tongue have been reported.

Atovaquone plus Proguanil

Brand: Malarone

• Do not confuse with Maloprim
• Should be taken for 1 or 2 days before entering the malaria area, throughout exposure, and for 7 days after leaving the infected area.
• Need only be commenced one or two days before exposure.
• Abdominal pain, headache, anorexia, nausea, diarrhoea, coughing and mouth ulcers can occur.
• Absorption may be reduced by diarrhoea and vomiting, and blood levels are significantly reduced with concomitant use of tetracyclines, metoclopramide and some other drugs.
• The proguanil component can delay the metabolism of the anticoagulant, warfarin, and result in bleeding. Those planning to take warfarin must discuss this with their doctor before starting any treatment.
• Use with caution with renal impairment.

Summary For African Travellers and Hunters

• Minimise the risk of mosquito bites by applying insect repellents especially at dusk when Anopheles mosquitoes prefer to bite.
• Always travel with an adequate supply of anti-malarial prophylactic drugs and take them regularly.
• Remember preventative measures are not 100% guaranteed. The most careful person may still get malaria.
• Remember just a general 'unwell' feeling may be falciparum malaria and early treatment is crucial.
• Make sure you have emergency evacuation cover which can be actioned immediately to get to at least the nearest city.

More On African Hunt Health

• Health Before Hunt
• Health During Hunt
• Health After Hunt
• Polio In Africa
• Tetanus In Africa
• Diphtheria In Africa
• Tuberculosis In Africa
• Measles In Africa
• Yellow Fever In Africa
• Typhoid In Africa
• Meningitis In Africa
• Hepatitis In Africa
• Rabies In Africa
• Cholera In Africa
• Schistosomiasis In Africa
• Malaria In Africa
• Malaria In African Hunting Countries
• African Tick Bite Fever
• Sleeping Sickness
• Insect Repellents For Africa

1. Home
>
2. African Hunt Health
>
3. Health Before Hunt
>
4. Malaria In Africa

Back to Top

Page Updated: Mar 2024