General Malaria Information

This information was provided by
The Malaria Research Programme of the Medical Research Council, South Africa

Risk Maps
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Malaria Advice for Travellers in Southern Africa

General Advice

1.Avoid being bitten by mosquitoes

The best prevention is personal protection against the mosquito. Malaria mosquitoes generally bite after dark. Wear long sleeves and trousers in the afternoon and evening; stay in-doors if possible. Use insect repellent on exposed skin. Sleep under a bednet or in a netted tent or hut or in a house or caravan with screens. Close windows and doors at night. Spray insecticide aerosol and/or burn mosquito coil at night.

2.Take prophylaxis in malaria risk areas

Get good advice before you plan your holiday. The appropriate prophylaxis for a given malaria area depends on several factors including:

  • The parasite's resistance to drugs in this area.
  • The safety of the drug.
  • The efficacy of the drug.
  • The degree of malaria risk in the area.(See map of risk areas in south Africa)
  • The risk of resistance to (or reducing the efficacy of) the drug, in the future, due to inappropriate use.

Take the pills same day each week when weekly, or at the same time of the day if daily.
Continue prophylaxis for 4 weeks after your return. Complete the course.

(a) Mefloquine

Mefloquine (Lariam®) has been taken by people up to 12 months without side effects, is highly effective and has a simple weekly dosage. However, it has a number of contra-indications and requires a doctor's prescription. It also has been known to have rare but severe neurological side effects.
Start a week or two before, to check for possible side-effects and continue for 4 weeks after leaving the area. Mefloquine should be taken on a full stomach.

(b) Doxycycline

This drug is highly effective in SE Asia where there is multi-drug resistance, and resistance is rare. However, it is for short term use only and can cause light sensitivity. Doxycycline should only be taken if other drugs are unsuitable. It has been known to render birth control pills ineffective when taken at the same time.

(c) Proguanil/Chloroquine combination

This combination should be used with caution as resistance has developed in Mozambique and other regions. Proguanil (Paludrine®) every day; Chloroquine (Daramal® / Nivaquine® / Promal® ) once a week.
This combination can be taken safely up to 3 months, very cautiously for 6.

Start a day before entering the malaria area, and continue for four weeks after you leave the area. It is generally well tolerated and is available without prescription. Disadvantages are poor compliance due to the complicated regime and widespread resistance particularly in SE Asia.

Also see Department of Health Prophylaxis Guidelines 2009

3. Carry your own malaria test

Test yourself immediately on first malaria symptoms.
There are several good rapid tests available now . Don't leave home without one.

4. Carry your own alternative medication

When travelling in Africa, make sure you have everything with you.

When you get malaria head for the nearest doctor. Show your test and ask to be treated.

If you have contracted malaria in spite of prophylaxis you will need Lumafantrine-artemether or quinine. Sulfadoxine-Pyrimethamine (Fansidar«) may suffice. But be aware that Sulfadoxine-Pyrimethamine resistance exists. Refuse chloroquine treatment.

5. Carry a do-it-yourself treatment

For the worst-case scenario, take along some Lumafantrine-artemether. If you get stuck and cannot get to a doctor, treat yourself.

This is for emergency situations only.Always seek medical help if at all possible.

6. Cancel / postpone your holiday if necessary

If you are pregnant or have small children, avoid a holiday in a high-risk malaria area / season.  

Websites and phone numbers offering advice and information

Also see Links to Malaria sites