The current Malaria Risk Map for South Africa as in 2018 shows that at-risk-for-malaria areas now include the whole of Vhembe as well as areas such as Alldays and Lephalale. Image: NICD.
Date: 02 February 2019 By: Jo Robinson
The National Institute for Communicable Diseases (NICD) announced in December that some changes had been made to the risk areas for contracting malaria since the last map had been released in 2013. On the latest map (2018), Louis Trichardt now falls within the low risk area, from which it had previously been excluded.
The entire malaria risk area has spread further towards the centre of Limpopo. Large swathes that were previously no risk areas are now at low risk, and some areas previously in low risk sections are now at moderate risk.
The entire Vhembe District currently falls in a risk area. The NICD states that the borders of risk areas should be regarded as approximate and that sporadic transmission may occur outside designated areas because infected malaria mosquitoes are sometimes transported outside the usual risk areas. This can cause what is known as “taxi, or suitcase, malaria”, which is infection outside of areas listed as at risk, especially at this time of year when people have recently returned from their holidays in high risk areas. For a period of four to six weeks after returning home after possible exposure, people are encouraged to take note of the onset of flu-like symptoms. These include fever, headache, chills or aches in muscles and the body. If these or similar symptoms arise, immediately see a medical practitioner to be tested for malaria.
As at the end of October 2018, more than 16 000 cases of malaria were reported across South Africa and 110 deaths reported for the season. Cases of malaria spiked in 2017 after an annual average of 7 600 reported cases for the decade preceding.
Malaria is endemic to Limpopo and the season for it runs from September to May. The NICD recommends using non-drug measures in low risk areas at this time, such as mosquito nets and repellents. If people are travelling through moderate risk areas, they recommend the use of prophylactic medication; however, this must only be done on the advice of a medical practitioner.
Local pharmacist Hanlie Nagel told the Zoutpansberger that they were well prepared for the malaria season and were well stocked with the relevant medications. The drugs doxycycline and atovaquone-proguanil have now been labelled as Schedule 2, which means that they can be purchased at pharmacies without prescription. Nagel said, however, that consulting a doctor for advice on when and how to take preventative medication was important, and that these two drugs were not necessarily what your doctor would prescribe for you, depending on your own medical history.
Dr Casper Venter told the Zoutpansberger that taking these drugs without medical advice was a very bad idea. They can have extremely dangerous side-effects for certain people as well as interact with other medications. While emphasising the importance of seeking proper medical advice before taking any drugs, Dr Venter said that even though no need existed to panic about the new risk areas, increased vigilance was important to catch malaria as early as possible. He said that the sooner treatment started the better. “If you are worried about malaria here, or planning to travel anywhere where diseases are endemic, consult your doctor first, rather than attempting to self-medicate.”
In a media statement last year, the spokesperson for the Limpopo Department of Health (LDH), Neil Shikwambana, said that “[t]he LDH is encouraging communities and health-care providers to be aware of malaria and not to delay seeking treatment and testing for malaria. Limpopo reported an increased transmission of malaria during 2017, with 17 765 cases reported between January and December 2017. This increase was part of a general upsurge of malaria in the area. In order to reduce the transmission of malaria, the LDH has 42 malaria teams operational to conduct the spraying of houses. Since August 2017, a total of 964138 houses have been sprayed. As there were higher levels of transmission towards the end of the summer in 2017 (May 2017), steps were taken to continue with spraying later into the malaria season”.
Currently, malaria spray teams are still actively spraying in high risk communities in Mopani and Vhembe. “Since the beginning of 2018, a total of 5 482 malaria cases were reported in Limpopo, down from the 6 079 cases reported over the same period in 2017. All health facilities in Limpopo are prepared to deal with malaria cases. All hospitals also have access to the latest malaria treatment regime available. If malaria is not diagnosed and treated in time, it can be fatal,” said Shikwambana.
Jo joined the Zoutpansberger and Limpopo Mirror in 2018 pursuing a career in journalism after many years of writing fiction and non-fiction for other sectors.