The recent death of two women in Doornpoort, in the north of Pretoria, due to malaria, is causing panic amongst people living in Tshwane. There is a lot of speculation, especially on social media, as to where the problem has originated from. In both cases neither of the two women had been to a malaria endemic area. Similarly a woman from North-West Province has also died due to malaria and her husband was infected. Both were nowhere near a malaria-endemic area.http://www.sanews.gov.za/south-africa/malaria-has-not-expanded-sa
Both the National Department of Health (NDoH) and the National Institute of Communicable Diseases (NICD) are busy investigating the reported malaria cases to determine the source of the malaria. The University of Pretoria Institute for Sustainable Malaria Control (UP ISMC) is busy with research on malaria vectors (mosquitoes), malaria parasites and human health. They have a trans-disciplinary approach towards malaria control and eventual elimination, with a strong focus on new innovations for malaria prevention.
Gauteng Province is not one of South Africa’s malaria endemic areas. The disease is endemic to low lying areas of Limpopo, Mpumalanga and north-eastern KwaZulu-Natal (KZN). However, Gauteng does have a high number of malaria cases annually and each year there are deaths reported in the province due to malaria. In 2014 there were a total of 1929 malaria cases reported in Gauteng and a total of 28 mortalities due to the disease. These numbers were the third highest amongst all the provinces in South Africa, and were even higher than that reported in KZN.
The origin of malaria cases in non-endemic areas is often identified as traveling malaria. That is when an infected Anopheles mosquito is transported from a malaria endemic area to a non-endemic area in a traveller’s suitcase or in a vehicle. In other cases people are infected when they have visited a malaria endemic area and often only start showing symptoms once they are home, in many cases a non-endemic area.
The NDoH, through its Malaria Control Programme, has done a remarkable job in ensuring that malaria cases in South Africa have decreased drastically and the aim is to eliminate malaria by 2018. However, there are major challenges being faced.
Malaria incidence in South Africa is impacted by the number of imported cases from South Africa’s neighbouring countries. A total of 69% of all the malaria cases (6 847 cases) reported in South Africa from January to December 2012 were imported from Zimbabwe and Mozambique.
Another challenge is the potential increase in malaria risk due to climate change. The distribution of malaria in 1938 included epidemic malaria occurring as far south as Pretoria and beyond Durban. With climate change the chance exists that the climate in South Africa may become more suitable for malaria – Climate change clouds SA’s plans to eradicate malaria, Mail & Guardian 10 April 2014 – essentially favouring malaria transmission and possibly reintroducing the disease in malaria-free areas. This raises the question if malaria would ever occur naturally in Pretoria again? This is surely something worth looking into.
According to Prof Tiaan de Jager, Director of the UP ISMC, they are not only looking at cross-border movement but are also doing work on climate, climate change and environmental factors affecting malaria.A project, using remote sensing for malaria control in collaboration with the SA Weather Services and the French National Space agency (CNES) will focus on all of the mentioned factors.
Malaria awareness is very important and communication of key messages is necessary. Awareness of the disease and the risks associated with it, especially in high risk areas, is the first step towards prevention. People need to be made aware of the disease in order to protect themselves, even if they do not live in an endemic area.
Malaria presents itself as bouts of fever accompanied by cold or flu-like symptoms, alternating with periods of absence of feeling sick. Intermittent symptoms include headache, malaise, fatigue, nausea, muscular pains, chills and even diarrhoea. People in endemic areas or those who have recently visited such an area should consult a physician or healthcare practitioner immediately when these symptoms appear especially during the malaria months. Symptoms of complicated or severe malaria include delirium, generalized convulsions, impaired consciousness and respiratory distress.
Prevention is better than cure, and therefore researchers at the UP ISMC do a lot of work on malaria prevention and education. When living in or traveling to a malaria area consider the following to avoid being bitten (also useful for non-malaria mosquitoes):
Avoid going out between dusk and dawn when Anopheles mosquitos usually bite.
Wear long-sleeved clothing if going out at night.
Avoid wearing dark colours because they attract mosquitoes.
Apply insect repellent to exposed skin.
Stay in a well-constructed and well-maintained building in the most developed part of town.
Use screens over windows and doors.
Use anti-mosquito sprays or insecticide dispensers, or burn mosquito coils at night.
Sleep under bed nets if available.
The UP ISMC released an app, ‘Malaria Buddy’, in collaboration with Travel with Flair in 2016. The first phase of the app was very basic with information on the disease, how to prevent getting sick and what to do if you suspect you have malaria. However, the Institute is currently busy working on phase 2 of the app, which aims to make use of GIS technology in order to make the app a ‘GPS’ to malaria hot spots and treatment options, simply by using the phone’s location.
The app is available to download on the iTunes store for iOS devices and Google play for Android devices. More information on malaria is available on the Frequently Asked Questions page (FAQs) of the UP ISMC website (www.malaria.up.ac.za).
Prof Tiaan de Jager
Director: UP ISMC
Phone: 012 319 2191
Dr Taneshka Kruger
Project Manager: UP ISMC
Phone: 012 319 2381
University of Pretoria, Prinshof Campus
31 Bophelo road