Anti-malaria prophylaxis for Southern Africa trip (6)
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According to the national health authorities, malaria transmission is
low in the Republic of South Africa and is limited to rural areas
(including game parks and natural reserves) in the northern, eastern,
and western low altitude areas of Transvaal and in the Natal coastal
areas north of 28 degrees southern latitude. Transmission occurs in
all lowland areas of Swaziland. The World Health Organization and the
Centers for Disease Control and Prevention recommend that nonimmune
travelers to risk areas of Southern Africa can reduce their risk of
acquiring malaria by:
1. Using personal protection measures such as protective clothing,
repellants and insecticide-treated bednets, especially during peak
biting times. The most common vector in rural Africa, Anopheles
gambiae complex usually bites between 11 pm and 4 am.
2. Taking prophylactic doses of an efficacious antimalarial drug. CDC
recommends weekly mefloquine; some European health authorities
recommend a combination of weekly chloroquine and daily proguanil.
To be effective, antimalarial chemoprophylaxis should be started at
least a week before travel to an endemic area and continued throughout
the stay and for an additional four weeks after leaving the risk area.
Perhaps the most important recommendation would be to consult with your
physician and seek advice from the health authorities in your own
country. Seeking medical advice over the internet is seldom advisable
and may end up providing conflicting, out-moded or ill-informed
responses.
S. Patrick Kachur, MD, MPH
Malaria Epidemiology Section
(U.S.) Centers for Disease Control and Prevention
mailto:spk0@cdc.gov
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