Malaria is a deadly infectious disease that kills over half a million people in Africa each year. Yet it is treatable, and nobody should die from the disease.
This is according to Prof Lucille Blumberg who recently received a lifetime achievement award for her contribution to the elimination of malaria in Southern Africa at the Southern African Malaria Research Conference.
Malaria, a red blood cell infection transmitted by the bite of a mosquito, is a preventable and curable disease. Awareness and precautions, especially before traveling to an area endemic for malaria, are important for the prevention of malaria. Travellers are most susceptible to bringing back infections. For example, in 2010, over 1 700 travellers were diagnosed with malaria after returning to the UK. Most of these cases were acquired in Africa. South Africans of all ages living in or visiting certain regions in Limpopo, Mpumalanga and northern KwaZulu-Natal are at risk. Many patients that present with malaria in South Africa have travelled to or from Mozambique.
In South Africa, malaria is present along the border with Zimbabwe and Mozambique. Specifically, in Mopani and Vhembe Districts of Limpopo Province; Ehlanzeni District of Mpumalanga Province; Umknanyakude District of KwaZulu-Natal Province. It is present in Kruger National Park, with a few cases in the Waterburg, Capricorn, and Greater Sekhukhune Districts of Limpopo Province; Zululand and King Cetshwayo Districts of KwaZulu-Natal Province.
The malaria species present is primarily P. falciparum. Less common, is P. malariae, P. ovale, or P. vivax.
Antimalarial drugs are used for the treatment and prevention of malaria infection. Most antimalarial drugs target the erythrocytic stage of malaria infection, which is the phase of infection that causes symptomatic illness. The extent of pre-erythrocytic (hepatic stage) activity for most antimalarial drugs is not well characterised. Treatment of the acute blood stage infection is necessary for malaria caused by all malaria species. In addition, for infection due to Plasmodium ovale or Plasmodium vivax, terminal prophylaxis is required with a drug active against hypnozoites (which can remain dormant in the liver for months and, occasionally, years after the initial infection).
Antiprotozoals are medicines that are used to prevent and treat malaria. A complete course of prescribed antimalarials before, during, and after travel is important in the prevention of acquiring infections.
This chemoprophylaxis and is useful for travellers. In SA, drug resistance has been shown with chloroquine. For the Mopani and Vhembe Districts of Limpopo Province; Ehlanzeni District of Mpumalanga Province; Umknanyakude District of Kwazulu-Natal Province; and in Kruger National Park, atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine are recommended. In other areas with malaria, mosquito avoidance only is recommended.
Reference available on request.