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Malaria occurs within the Lowveld areas of Mpumalanga, right through the
year.
Malaria is spread by the Anopheles mosquito, so
preventing yourself being bitten is of paramount
importance.
Mosquito nets and repellents are strongly
recommended after sundown.
Try to avoid being bitten by
wearing clothing that covers the arms,legs and ankles and use
repellant' - (See DEET below) - on the exposed parts of your
body as well as sleeping under treated mosquito nets.
When
in malaria areas use effective DEET insect repellents
(containing Diethyltoluamide).
Try and ensure that the
doors and windows of your accommodation are screened against
mosquitoes and try and keep them closed, especially before
dusk. Having a fan or air-conditioner on at night will keep
mosquito activity down to a minimum.
Malaria prophylaxis is recommended for all travelers to
Mpumalanga Lowveld.
The three most commonly used ones are;
1.)Mefloquine (Lariam);
2.)Atovaquone/proguanil
(Malarone)(PDF);
3.)Doxycycline.
1.)Mefloquine is
taken once weekly in a dosage of 250 mg, starting one-to-two
weeks before arrival and continuing through the trip and for
four weeks after departure.
Mefloquine may cause mild
neuropsychiatric symptoms, including nausea, vomiting,
dizziness, insomnia, and nightmares.
Other reactions can
occur, including depression,anxiety, psychosis,
hallucinations, and seizures.
Mefloquine should not be
given to anyone with a history of seizures, psychiatric
illness, cardiac conduction disorders, or allergy to quinine
or quinidine.
Those taking mefloquine (Lariam) should read
the Lariam Medication Guide and possibly conduct tests before
they depart.
2.) (PDF). Atovaquone/proguanil (Malarone)
is a recently approved combination pill taken once daily with
food starting two days before arrival and continuing through
the trip and for seven days after departure.
Side-effects,
which are typically mild, may include abdominal pain, nausea,
vomiting, headache, diarrhea, or dizziness. Serious adverse
reactions are rare.
3.)Doxycycline is effective, but
may cause an exaggerated sunburn reaction,
which limits
its usefulness in the tropics
Syptoms such as fever, chills, headaches, and
muscle aches, should be considered as an indication of
malaria.
Malaria symptoms can sometimes not occur for
months or even years after exposure. |
Diarrhoea is a very common ailment when travelling.
Most cases of diarrhoea when travelling are mild and do not
require either antibiotics or anti-diarrhoea
medicines.
Adequate fluid intake is essential for any
traveller suffering from diarrhoea, to prevent dehydration.
The most important aspect of preventing diarrhoea is
treatment and care, as far as food and water intake is
concerned.
Travelers are advised to carry with them an
antibiotic as well as an anti-diarrhoea drug, to be taken as
soon as significant diarrhoea starts.(Three or more loose
stools in an 8-hour period or five or more loose stools in a
24-hour period)
If diarrhoea is combined with nausea,
vomiting, cramps, fever or blood in the stool, an antibiotic
should be administered.
Ciprofloxacin (Cipro)(PDF) 500 mg
twice daily or
Levofloxacin (Levaquin) (PDF) 500 mg once
daily for a total of three days.
Quinolones are generally
well-tolerated, but occasionally cause sun sensitivity and
should not be given to children, pregnant women, or anyone
with a history of quinolone allergy.
An alternative
treatment could be a three day course of rifaximin (Xifaxan)
200 mg three times daily or azithromycin (Zithromax) 500 mg
once daily.
Rifaximin should not be used by those with
fever or bloody stools and is not recommended for pregnant
women or children under the age of 12.
Azithromycin should
be avoided in those allergic to erythromycin or related
antibiotics.
An antidiarrhoea medicine such as loperamide
(Imodium) or diphenoxylate (Lomotil) should be taken as needed
to slow the frequency of stools, but not enough to stop the
bowelmovements completely.
Diphenoxylate (Lomotil) and
loperamide (Imodium) should not be given to children under the
age of 2.
If diarrhoea is, severe, bloody, or if fever
occurs accommpanied by shivering and chills, or if abdominal
pain becomes severe, or if diarrhoea lasts for more than 72
hours, medical attention should be sought.
Although
antibiotics are effective, they should not be taken as a
prophylactic.
Food and water precautions;
Don't drink tap water unless
it has been boiled, filtered, or chemically disinfected.
Don't drink unbottled beverages or put ice in your drinks
unless you know that the ice is safe to drink.
Don't eat
fruit or vegetables unless they have been washed very
thoroughly peeled or cooked.
Avoid cooked foods that are
no longer hot. because cooked food that has been left at room
temperature can be very dangerous.
Avoid unpasteurized milk
and any products that might have been made from unpasteurized
milk.When using powdered milk make sure the water you mix it with is safe.
Avoid food and beverages obtained from street
vendors.
Do not eat raw or undercooked meat or fish.
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