Mosquitos mostly just annoying can become frightening with the threat of Malaria and other mosquito borne diseases.
“You’ve got to be kidding me?”
Sadly Sheila wasn’t. Our friend in Malawi was dead. Malaria.
This was a bit too close for comfort. We’d heard about the threat of Malaria north of South Africa. We’d heard that this mosquito borne disease can be deadly. But a friend? According to the World Health Organization, Malaria is one of the top five killers in Africa.
What is Malaria?
“Malaria, caused by the Plasmodium parasite, is spread by the night-time – dusk to dawn – biting female Anopheles mosquito. The mosquitoes don’t hum and don’t create a welt at the site of the bite, so a person does not know that they have been bitten. This preventable disease affects between 124 million and 283 million people worldwide every year. Of the five species of human malaria parasites, Plasmodium falciparum is the most dangerous. The other types of malaria are caused by Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi.” [iamat.org]
Where is the threat of Malaria present in Africa?
Is there a vaccine to prevent Malaria?
“Despite many decades of intense research and development effort, there is no commercially available malaria vaccine at the present time” [who.int]
How scary is Malaria?
Admittedly the fear of contracting Malaria was a factor that kept us south a year longer. Then in mid-2016 we decided we’d go for it. Wildlife conservationists we’d met via Facebook were waiting.
We left South Africa in October 2016, heading north through Botswana, Zimbabwe, Mozambique, Malawi, Tanzania, Rwanda, Ugandan, Kenya and back down again. The entire circuit would take us about six months. Five of which would be in Malaria country. And at least two where Dengue and Yellow Fever added to the threat of mosquito borne diseases.
How do we protect ourselves against Malaria?
Supposedly partial immunity to Malaria can be developed during years of exposure, however, no one becomes fully immune. Travelers, or infrequent visitors in Malaria country are the most at risk. Add to this the higher risk of young children and the elderly. Russ and I, being in our mid-sixties are considered elderly. After all, the doctor in Pietermaritzburg gave us Yellow Fever vaccination exempt cards due to age!
In the past we’ve had adverse effects to Malaria pills. So we decided to forgo them, at least at first. Russ researched the best mosquito repellents and purchased several different brands. (The most easily available Tabard lotion turned out to be the best.) He bought permethrin spray. We picked a pair of long pants, long sleeved shirts and socks each. He sprayed them. We each tucked them in a separate bag for anti-mosquito use only.
Once we hit Zimbabwe we began our dusk and dawn routine. Lotion on all exposed body parts and dressing in our permethrin sprayed clothes.
I noticed every insect bite like never before. Was it a mosquito bite? Was it a Malaria carrying mosquito? Was I going to die? Crazy? Yes, but while living with the threat of Malaria this thought process was very real.
When we reached Malawi I was still getting about a bite a day. This despite my vigilant application of repellent before sundown and before emerging from the tent at dawn. At Cape Maclear on Lake Malawi we camped next to a couple from France. They were taking Doxycycline with no side effects! We decided to try it.
What is Doxycycline?
“Doxycycline is a tetracycline antibiotic that fights bacteria in the body. Doxycycline is used to treat many different bacterial infections, such as acne, urinary tract infections, intestinal infections, eye infections, gonorrhea, chlamydia, periodontitis (gum disease), and others.” [drugs.com]
It is also used as an anti-malaria drug. It is a milder and cheaper alternative to other Malaria preventative medications. [See below]
Beginning in November through the end of April we religiously took our green capsule every day. The only side effect we experienced was a looser stool. For older folk this can be quite helpful. At first I had a bit of tummy discomfort as well. I learned quickly that eating yogurt daily with breakfast cleared that up. The challenge was finding yogurt in some places. When we did, we stocked up and rationed it (as we did other hard to find food items.)
Along with our daily regime of lotion, permethrin clothes and pill we bought Malaria test kits and the treatment pills. We never needed the treatment pills. Although Malaria can still rear its ugly head up to one year after leaving Malaria country. So we have a bit to go yet. We will be keeping the remaining test kits and the treatment tablets with us.
While in Dodoma Tanzania, waiting for parts to arrive for our Land Rover, Russ developed a fever. No other symptoms. The second night I grabbed a Malaria test kit. As I’m horrible with the sight of blood Russ had to jab his own finger. We waited during the long 20 minutes… negative. Hooray! This ruled out Malaria, but what about Yellow Fever and Dengue? The presenting symptoms are quite similar. Fortunately, after the fifth night of the fever recurring it finally abated.
Here are some other tips when living with the threat of Malaria and other mosquito borne diseases. Though no matter how much you do, my guess is you’ll be like me… and get a bit nervous every time you get an insect bite.
Nine tips to help prevent malaria
ONE: Determine your level of risk
- Look at the risk of the country/countries you’re visiting
- How populated are the areas you’ll be staying at?
- Is it the wet or dry season?
TWO: Stay in well-screened areas at night
- Not so easy when you’re camping and living out doors
- Do avoid standing water areas to camp if possible
THREE: Always use a bed-net impregnated with insecticides
- If you’re sleeping in a tent be sure to keep it well zipped up at night
FOUR: Use mosquito repellent
- An absolute must
- Be sure to check how many hours it’s good for
- In the Yellow Fever and Dengue countries also apply a long lasting repellent during the day
FIVE: Go for long sleeves
- Wearing long pants, a long sleeved shirt and shoes and socks, even when it’s hot are worth it.
- Treating your clothes with permethrin may also help protect you.
SIX: Sunscreen comes first – repellent second
- If you are using sunscreen, it should be applied first and the insect repellent second.
SEVEN: Assess the risks – Get an antimalarial (if necessary)
- Malarone (Atovaquone-Proguanil): one tablet once a day starting 2 days before you go, during your stay and for 7 days after you return
- Doxycycline: one tablet once a day starting 2 days before you go, during your stay and for 4 weeks after you return
- Avloclor (Chloroquine): two tablets taken once a week starting 1 week before you go, during your stay and for 4 weeks after you return
- Lariam (Mefloquine): one tablet taken once a week starting 3 weeks before you go, during your stay and for 4 weeks after you return [dred.com]
EIGHT: Know the symptoms of Malaria
- Malaria infections are characterized by fever, headache, muscle ache, chills, fatigue, and vomiting usually appearing 7 to 15 days after being bitten by an infected mosquito. However, you’re not out of the woods until a year after being bitten. [mmv.org]
NINE: Do your own research before you venture into Malaria country
- Much is available on the web when you key in ‘Malaria prevention’.
Everything considered living with the threat of Malaria and other mosquito borne diseases has been well worth it, for us. We plan to go north again in 2018 to visit the fine people we found saving wildlife. People like Baye, Moses, Lynn and Connex, Philipo, Raphael, Said, Hope and others.