RECOMMENDATIONS FOR SOUTH AFRICA The malaria risk areas in South Africa are regarded as chloroquine-resistant. The risk areas can conveniently be divided into high,
intermediate and low risk areas (Figure 2). The determination of the risk areas is based on notified malaria cases during the past 10 to 15 years in the areas.
In all the risk areas precautionary measures to prevent mosquito bites should be taken throughout the year. In the high risk areas
the use of antimalarial drugs is recommended from October to May. The drugs listed above for chloroquine-resistant areas are recommended. The
intermediate risk areas
(only in KwaZulu-Natal) include the following tourist areas: Kosi Bay, Sodwana Bay, Mkuze Game Reserve and St Lucia Lake (not the town of St Lucia and the river mouth). In these areas the use of antimalarial drugs is recommended only for
high risk peopleA from October to May. The drugs listed above for chloroquine-resistant areas are recommended. In the low risk areas
no antimalarial drugs are recommended. In the North-West and Northern Cape provinces along the Molopo and OrangeRivers, including the Augrabies Falls and the Kalahari
Gemsbok National Parks, there is only occasionally local transmission of malaria. It is not necessary to take antimalarial drugs when visiting these areas. Since there may be
other mosquitoes causing a nuisance present along these rivers during the rainy season, precautionary measures to prevent mosquito bites can be taken. Residents in malaria areas Residents in high, intermediate
and low risk malaria areas should take precautionary measures against mosquito bites throughout the year. High risk people should consult their medical practitioners for advice on the
taking of antimalarial drugs during the summer months. RECOMMENDATIONS FOR OTHER COUNTRIES (FIGURE 1) Table 2 contains an alphabetical list of the countries/islands in the world where there is a malaria risk. The risk areas in these countries/islands
are divided into chloroquine-sensitive (CS) and chloroquine-resistant (CR) areas. The drug(s) recommended above for the specific CR or CS areas are recommended. Some countries are
indicated as having both CS and CR areas - prophylactic drugs are recommended according to the risk of the specific area being visited.In all malaria risk areas
precautionary measures against mosquito bites are recommended throughout the year. In some countries where there is a very low risk of malaria, only measures against mosquito bites
are recommended without antimalarial drugs. A
High risk people are children under 5 years, pregnant woman and immunocompromised persons, e.g. a person who had a splenectomy or is on immune suppressant medication such as cancer chemotherapy.
The guidelines are endorsed by the Medical Association of South Africa. |
