Health considerations when travelling to a malaria area

Posted on 6 November 2018

Malaria continues to be a major killer worldwide, especially in Africa. It’s vital you take the necessary steps to protect you and your family when travelling to a malaria area.

Malaria is translated from the Italian, ‘mala aria’, meaning ‘bad air’. The term originally referred to the inhospitable atmosphere caused by the exhalations of marshes, which was thought to be the cause of the disease.

The real culprit is now known: malaria is transmitted through the bite of an infected female Anopheles mosquito. This disease is a major cause of death globally, specifically in Africa. Worldwide, 212 million malaria cases and 429 000 malaria-related deaths are reported every year, according to the World Health Organization (WHO).

Dr Stefan Basson, principal clinical manager of the Emergency Centre at Mediclinic Nelspruit in Mpumalanga, says 9 478 cases of malaria were reported in South Africa during the 2016/17 season, up from 6 375 in the previous year.

“Malaria should be suspected in any person presenting with an acute febrile illness (fever), who has a history of travel to, or residence in, a malaria transmission area,” says Dr Delene Brink, a medical microbiologist. “Signs and symptoms of malaria are non-specific and a high index of suspicion is needed,” she warns.

Holiday vaccinations

Malaria symptoms 

“Patients present with malaria 7-21 days after being bitten by an infected mosquito, but longer incubation periods may occur in patients who have failed chemoprophylaxis or who have taken antibiotics for other reasons,” Dr Brink explains.

  • One of the first symptoms is fever
  • Rigours/chills
  • Fatigue
  • Night sweats
  • Shivering and sweating

The National Institute for Communicable Diseases (NICD) says it’s important to assess the malaria risk of your destination before you go, by considering the following:

  • Where are you going – investigate a malaria map before you go
  • When? The high-risk season is September to end of May
  • Type of accommodation?
  • Duration of stay?


The only way to ensure you don’t contract malaria is to avoid mosquito bites, says the NICD.

You can do this by:

  • Remaining indoors between dusk and dawn, when you’re more likely to get bitten by mosquitoes
  • Wearing long, preferably light-coloured clothing
  • Using mosquito repellents containing DEET (N, N-diethyl-3-methylbenzamide or N, N-diethyl-m toluamide), during outdoor activities
  • Repellents should be applied to exposed skin surfaces and repeated after four to six hours according to the manufacturer’s instructions
  • Sleeping under insecticide-treated bed-nets
  • Ceiling fans and air conditioners are also effective in preventing mosquito bites
  • According to the Centers for Disease Control and Prevention (CDC), no anti-malarial drug is 100% protective and must be combined with the use of personal protective measures

How to prevent contracting malaria during your next holiday [Internal link:]

Choosing anti-malarial drugs

Prophylaxis works in various ways, but basically suppresses the establishment of the infection in the liver, according to Dr Basson. “The medication is only available via prescription, so it’s absolutely imperative that you see your doctor or visit a travel clinic before travelling to a malaria region,” he says.

Dr Brink recommends the following prophylaxis against malaria:

Atovaquone/Proguanil (daily)

Start one or two days before entering a malaria area and take daily while there, and for seven days after leaving the area.

Doxycycline (daily)

Start one day before entering a malaria area and take daily while there, and for four weeks after leaving the malaria area.

Mefloquine (weekly)

Start at least one week before entering a malaria area and take once weekly while there, and four weeks after leaving the area.


Published in Healthy Life

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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