Malaria in Africa

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QUESTION

How many in Africa have been affected by Malaria?

ANSWER

In 2010, there were approximately 174 million cases of malaria in Africa. However, some people may present with more than one case of malaria per year (especially young children), so the number of people affected is likely considerably lower. However, 90% of deaths from malaria occur in Africa, and 60% in just six countries: Nigeria, DR Congo, Burkina Faso, Mozambique, Cote d’Ivoire and Mali. The good news is that malaria mortality has dropped by 33% in Africa since 2000, which is a very encouraging trend, though the aim of organizations such as Malaria No More is to fully eliminate deaths from malaria globally by 2015.

Malaria in Southern Africa

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QUESTION

Which areas in southern africa harbour malaria?

ANSWER

Most of Namibia, Botswana and South Africa does not harbor malaria, either because it is too cold, too dry, or control measures have successfully eliminated transmission. However, malaria transmission is found in virtually all parts of Zimbabwe and southern Mozambique.

In addition, pockets of malaria transmission can be found in parts of the other countries of southern Africa, namely in northern Namibia (provinces of Kunene, Ohangwena, Okavango, Omaheke, Omusati, Oshana, Oshikoto, and Otjozondjupa and in the Caprivi Strip), in northern Botswana (Central, Chobe, Ghanzi, Northeast, and Northwest provinces) and also 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.

Malaria in KwaZulu Natal

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QUESTION

How many people are infected by malaria in KZN?

ANSWER

By “KNZ” I assume you mean KwaZulu Natal (for the benefit of other readers, this is a region of South Africa, in the north-eastern portion of the country). KZN is one of the few parts of South Africa that experiences malaria transmission, though effective control measures have reduced its impact as a public health threat.

Up until 1996, South African policy had been to use DDT (even though it was a banned substance) to control mosquito populations, and malaria levels had correspondingly been low. However, after cessation of spraying with DDT, the number of malaria cases increased, to a high of over 40,000 cases in the 1999/2000 malaria season (in KZN, malaria is most commonly transmitted during the wet summer months, from November to May). Since then, the use of DDT as an insecticide has been reintroduced (along with other public health measures, such as switching to artemisinin-based combination therapies for first-line malaria treatment), and the burden of malaria has plummeted.

The most recent data I could find reported less than 3500 cases for the 2001/2002 malaria season, and zero cases in 2002/2003 (though the data I found were only up to February 2003). Efforts to coordinate malaria control between South Africa, Mozambique and Swaziland have also contributed to the success of reducing malaria transmission in the region.

Recurring Malaria Long Term Effects

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QUESTION:

Hi, my husband is an expat working in Mozambique for the past 5 years. He has been diagnosed with malaria 9 times, what are the long term effects of this and is he just unlucky or do others also get infected often? thanks.

ANSWER:

If the proper precautions are not taken, then it is very easy to get infected with malaria multiple times; I have one Ugandan colleague who claims he gets sick at least once a year from malaria, usually sometime in the rainy season. However, there are means to protect oneself from regular infection, and it might be that your husband could be more vigilant about such methods of prevention. For example, he should make sure he sleeps under a long-lasting insecticide treated bednet, which drastically reduced the risk of being bitten by mosquitoes at night. Similarly, he should try to wear long trousers and long-sleeved shirts, preferably impregnated with a substance called permethrin (an insecticide which prevents mosquitoes from biting through clothing – it can be purchased at most camping stores and sprayed directly onto clothing only, not onto skin), especially at dawn, dusk and at night, when malaria-carrying mosquitoes are most active. When mosquito numbers are high, he could also use insecticide that contains DEET on any exposed skin as a further precaution against bites.

The good news is that if his previous bouts of malaria have been uncomplicated, and diagnosed and treated quickly, there should be no long term effects of having had the infection.