Malaria

Malaria is a serious and sometimes potentially terminal condition caused by infection with the microscopic parasite Plasmodium. Plasmodium is transmitted to humans through bites from Anopheles mosquitoes which are infected with the parasite. According to the World Health Organisation, malaria is present in more than 100 countries - mostly in sub-Saharan Africa and South-east Asia. In Southern Africa it is prevalent in Mozambique, Mpumalanga and in the northern parts of Kwazulu-Natal. Random cases are seen in people who originate from these areas, contract the condition during a visit and return to metropolitan areas where they work.

Symptoms
Symptoms usually appear about nine to 14 days after being bitten by an infected mosquito. These may include:

• sudden, violent chills
• headaches
• intermittent fever
• seizures
• sweating
• confusion and hallucinations
• exhaustion.

When a child or pregnant woman contracts malaria, the condition may be more severe and urgent medical attention must be sought. If a person does not recuperate quickly on treatment, medical advice and treatment must be sought to determine whether admission for the severe form of malaria is needed.

Diagnosis and treatment

• Malaria is best diagnosed by using a microscope to identify the Plasmodium parasites in a blood sample.
• Malaria is treated with drugs that interfere with the parasite's life cycle or metabolism. Effective drugs to treat the condition are available. Your doctor will decide which drug to give you.
• If you think you have malaria, you should seek medical treatment immediately.

Prevention
Prevention is based on avoiding exposure to mosquitoes and aggressively treating people who are infected. Malaria control programmes in many parts of the world receive inadequate funding and are ineffective. If you are travelling to an area where malaria is common it is advisable to do the following:

Take preventative anti-malaria drugs exactly as prescribed by your physician and prevent mosquito bites by:

• closing windows at night if possible
• sleeping with a mosquito net, preferably one containing an insecticide, with the edges tucked under the mattress
• covering up your body as much as possible with clothing (especially during the early morning and evening). Long-sleeved shirts and trousers are recommended
• applying an insect repellent to areas of the body not covered by clothing.

Note that Mefloquine (Lariam® and generic variations thereof) should not be taken by patients with potentially dangerous occupations or hobbies, such as pilots, scuba divers, etc.
Regard all areas of the Lowveld of South Africa and northern KwaZulu-Natal as malaria areas, even during winter months.

References
1. Merck Manual (Home Edition) Malaria. March 2007.
2. Up To Date: Prevention of malaria infection in travellers. May 2010