Malaria cases in South Africa are increasing as expected during the summer months. The higher temperatures and recent rainfall experienced in transmission areas will likely increase malaria mosquito populations and may result in higher malaria transmission rates in the coming months. Within the usual risk areas in South Africa (as shown in the malaria risk map), Bushbuckridge (Mpumalanga Province), Vhembe and Mopani (Limpopo Province), and northern KwaZulu-Natal Province may experience higher than usual malaria transmission. Outside South Africa, the risk of malaria in Mozambique is particularly high.
People who are planning to travel are urged to take adequate measures to protect themselves from malaria. All people in malaria risk areas should reduce contact with mosquitoes by limiting outdoor activity after dark, covering up bare skin (not forgetting feet and ankles), using mosquito repellents containing DEET, ensuring mosquito screens on windows are closed, and using bednets, fans or air-conditioning, if available. In the higher risk areas, consider antimalarial prophylaxis, namely doxycycline and atovaquone-proguanil, available without prescription from pharmacies. Public sector travel clinics will also supply prophylaxis to travellers. Pregnant women should avoid travelling to transmission areas, as there is presently no suitable prophylaxis available in South Africa.
It is important to understand that while these precautions will substantially reduce the chance of acquiring malaria, the risk is never completely abolished. All travellers returning from malaria transmission areas, including very low risk ones, should report ’flu-like illness (headache, fever, chills, fatigue, muscle and joint pain) that occurs up to four weeks after first possible exposure, in case it is malaria. Children with malaria may have very non-specific signs (fever, loss of appetite, vomiting). Healthcare workers seeing ill patients must remember to ask about travel to malaria transmission areas. Do not forget that sometimes, infected mosquitoes may accidentally be transported in vehicles or luggage and transmit malaria in non-endemic areas!
The malaria risk map, FAQs and further information on prevention are available on the NICD website: www.nicd.ac.za.
Updated: 03 March 2020