Do I need malaria tablets to live in Nigeria?

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QUESTION

Do I need malaria tablets to live in Nigeria? I was born and bred in the UK and want to go back to live in Nigeria for about 2 years, do I need malaria tablets?

ANSWER

It is not usually recommended to take malaria tablets for long periods of time (i.e. more than a few months). People living for extended periods in areas with malaria should focus on other methods of prevention, such as sleeping under a long-lasting insecticide-treated bednet.

The mosquitoes that carry malaria, Anopheles, feed mostly in the evenings and at night, so it is particularly important to protect yourself during these times. Screening windows and doors tightly can help prevent mosquitoes form entering, as can air conditioning inside the house (it makes the climate less suitable for the mosquitoes).

In many parts of Africa, insecticide is sometimes sprayed indoors, again to prevent mosquitoes from being inside the house. Personal protection is also important; wearing long-sleeved clothing, particularly at dawn, dusk and at night, can prevent mosquitoes from biting you, as can wearing mosquito repellent, particularly kinds containing the chemical DEET.

Regarding tablets to prevent malaria, if you really want to pursue this option, the only medication which is recommended for long-term use is doxycycline, but you should consult with your doctor about its suitability for periods of longer than 6 months, and they should also explain to you the possible side effects associated with taking it.

While the above mentioned forms of prevention should be the mainstay of your efforts to avoid malaria, it is also important to know what the symptoms are and what to do if you suspect you might be infected.

Malaria is characterized by high fever, chills, aches and nausea most commonly, and if you think you may be infected, you should immediately go to a doctor or a clinic for diagnosis. The doctor/clinician should take a blood sample and either look at it under a microscope to look for malaria parasites or they will use a drop of blood in a rapid diagnostic test. In both cases, you should only take medication to treat malaria if you are positively diagnosed.

Socio-Economic and Environmental Conditions Contributing to Malaria

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QUESTION

what socio-economic and environmental conditions contribute to the disease?

ANSWER

Malaria transmission requires the presence of Anopheles mosquitoes; as such, conditions which favor the growth and persistence of these mosquitoes will also be hotspots for malaria transmission, provided the climate is also sufficiently warm for the development of the parasite within the mosquito.

Rural areas without sophisticated water and sanitation systems often utilize streams or ponds for everyday water needs; if these produce stagnant patches of water, they can be an ideal location for the development of mosquito larvae. Similarly, if rural farmers dig canals or ditches to irrigate their fields, these can become breeding areas. Urban areas tend to have less standing water, apart from cisterns, so in many cases transmission is less prevalent in urbanized locations. As a further socio-economic factor, preventing mosquitoes from entering the house and biting people is  key way to prevent infection. Rich people in malarial areas may be more able to have fully screened houses, possibly even with air-conditioning, which will prevent mosquitoes from establishing in the house. They may also be more likely to have access to a long-lasting insecticide treated bednet, which further reduces mosquito bites, and also access to accurate diagnostic screening and treatment, if they do happen to get infected.

All of these factors contribute to making malaria burden highest in some of the world’s poorest areas, with the highest levels of mortality in sub-Saharan Africa.

Malaria and Employees

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QUESTION

I have a domestic employee that has malaria. I also have a 1 year old baby at home. Is it safe to keep her in employ or should I grant her leave until she is fully recovered?

ANSWER

Malaria cannot be transmitted between people directly. It is transmitted via the bite of an infected mosquito. As such, the only way your baby could get malaria from your employee is if a mosquito bit the employee, then directly bit your infant. Therefore, the best way to prevent transmission of malaria in this case is to make sure both your employee and your child sleep under long-lasting insecticide treated bednets.

You should also make sure your windows and doors are screened, to prevent the entry of mosquitoes that could carry malaria. These mosquitoes feed mainly at night and in the evenings and early mornings, so during these times, you should take extra precautions against getting bitten, such as wearing long sleeved clothing and covering exposed skin in insect repellent. If you have air conditioning, having this on at night can also prevent mosquitoes from entering rooms. You should also make sure your employee gets appropriate treatment for malaria and takes the full course of medication.