Malaria in South Africa

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QUESTION

What are the high, low and no-risk areas for malaria in South Africa?

ANSWER

Malaria has been successfully controlled in many parts of South Africa, with the result that most of the country is not at risk for malaria transmission. However, some pockets of higher risk remain in the north-eastern corner of South Africa (north-eastern KwaZulu-Natal, with the southern-most limit of transmission corresponding with the Tugela River, Limpopo (Northern) Province, and Mpumalanga Province). Malaria is also transmitted in Kruger National Park.

Are Anti-malaria pills necessary if no mosquito bites?

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QUESTION

We had a weekend in the Kruger Park and all of us took anti malaria pills beforehand. None of us was bitten or even saw a mosquito, do we need to carry on taking them for so long?

ANSWER

Since you say “so long”, I assume you are either taking doxycycline or Lariam, both of which are taken for four weeks after leaving the malarial area. Unless you are experiencing severe side effects, it is always recommended to continue taking prophylactic medication for the full course, the reason being that the malaria parasite has a latent period of up to a few weeks, and the prophylactics only kill the parasite after this latent stage. Even though you didn’t see any mosquitoes, the possibility remains that you got bitten and did not notice – ultimately, you can weigh up the slight inconvenience of taking the pills for a while longer versus the slight risk, but enormous inconvenience of getting malaria!

Since you have taken malaria prophylactics, please take a moment to fill out the Malaria Medication Side-effects Survey: Treatment and Prophylaxis!

Thank you!