GUIDELINES FOR THE TREATMENT OF MALARIA IN SOUTH AFRICA 2016

The Department of Health and the South African Malaria Elemination Committee (SAMEC)

South Africa has played a leading role in the control of malaria for almost a century and has dramatically reduced its burden of malaria since 2000. This has paved the way for our commitment to eliminate malaria READ MORE ...

 

Important diseases at a glance (0)

Additional categories

African Tick Fever (0)

African tick fever is common, occurs throughout the year and does pose a risk for any persons going on hikes in the bush. Prevention of tick bites by wearing long pants, application of DEET-containing insect repellents to exposed areas, and checking for ticks after hikes and careful removal if found. While most disease is mild, complications do occur especially with delayed treatment. Doxycycline is highly effective if given early. Recognition of the disease is however a problem in countries where the disease does not occur.

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Bilharzia (2)

Bilharzia does occur in many rivers of the country. It can be prevented by not swimming in rivers.

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Cholera (1)

Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not promptly given. Vomiting also occurs in most patients.

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Dengue fever (2)

Dengue is transmitted by the bite of an Aedes mosquito infected with any one of the four dengue viruses. It occurs in tropical and sub-tropical areas of the world. Symptoms appear 3—14 days after the infective bite. Dengue fever is a febrile illness that affects infants, young children and adults.

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Hepatitis A (1)

Hepatitis A is caused by infection with the hepatitis A virus (HAV) and it has an incubation period of approximately 28 days.

HAV infection is primarily transmitted by the faecal-oral route, by either person-to-person contact or consumption of contaminated food or water, and the virus can survive in the environment for prolonged periods of time.

Infections occur early in life in areas where sanitation is poor and living conditions are crowded. With improved sanitation and hygiene, infections are delayed and consequently the number of persons susceptible to the disease increases.

South Africa has pockets of high and low endemicity. Whether or not vaccination is required will depend on the traveller's country of origin, previous exposure to HAV and activities that are undertaken whilst in South Africa. Seek advice from your health care provider.

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Hepatitis B (0)

Hepatitis B is a major public health problem in Sub-Saharan Africa, with at least 65 million carriers. It is a highly endemic area, with a seroprevalence of > 8%. South Africa has pockets of high and intermediate endemicity. Vaccination against Hepatitis B was introduced into the expanded programme of immunisation in South Africa in 1995 which has resulted in a reduction in the number of Hepatitis B carriers. Prior to introducing the vaccine in the Exapnded Programme of Immunisation, chronic carriage rate varied from 15.5% in rural areas to 1.3% in some urban areas. These numbers have decreased since the introduction of the vaccine.

Whether or not vaccination is required will depend on the traveller's country of origin, possible previous exposure to the virus and activities that are undertaken whilst in South Africa. Seek advice from your health care provider.

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Hepatitis C (1)

Hepatitis C is a contagious liver disease that results from infection with the hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness.

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HIV/AIDS (1)

The human immunodeficiency virus (HIV) is a retrovirus that infects cells of the immune system, destroying or impairing their function. As the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to infections. The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS).

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Influenza (seasonal) (1)

In Southern Africa, the influenza season starts in May/June and continues into August/September. If travelling during this period, the vaccine should be administered at least two weeks prior to arrival in South Africa to allow time for the immune response to develop. The vaccine does not contain live virus and is considered safe in transplant recipients and immunosuppresed travellers, but the protective effect of the vaccine is likely to be less in this group but would still reduce complications of influenza. Medication to treat influenza (oseltamivir- 'Tamiflu') is available on prescription in South Africa.

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Malaria advice for travellers (10)

The risk for malaria increases from September and September to May is considered the malaria season. Overall control initiatives have been very successful in the malaria transmission areas. Mostly falciparum malaria is seen. The risk remains low in KwaZulu-Natal and is confined to the very far northern KZN.

There is no malaria in the Drakensberg, Hhluhlwe and Umfolozi Game Parks and St Lucia areas. The risk of malaria in the Kruger National Park will increase and malaria chemoprophylaxis needs to be considered.

Mozambique has year round malaria and the risks in southern Zambia, Zimbabwe (Vitoria Falls) will likewise increase.

Measures to reduce mosquito bites (the malaria mosquitoes are most active from sunset to sunrise) are essential and include application of DEET containing insect repellents to exposed areas, wearing of long pants and socks and sleeping under a mosquito net.

To view the South Africa malaria map, click here ...

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Meningococcal Meningitis (1)

A seasonal increase of meningococcal disease is observed from April- October. Epidemics do not occur and the usual pattern is rather of sporadic cases. Pre-travel vaccination with the conjugate quadrivalent vaccine is safe and may be considered.

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Rabies (3)

Important animal species associated with rabies in Africa are dogs, cats, cattle, mongoose, bat-eared foxes, and jackals. Animal rabies is endemic in South Africa and both wild and domestic animals are important reservoirs. All mammals are susceptible to rabies and can transmit rabies virus, but dogs are the most important source of human rabies infection in Africa, as well as the yellow mongoose. Globally, dogs are the major reservoirs. Dog rabies in South Africa is most prevalent in KwaZulu-Natal, Limpopo, Eastern Cape and Mpumalanga Provinces.

There have been a number of successful control initiatives in the province of Kwazulu Natal. Most of the cases occur in rural areas.

There is a low risk when travelling in more rural areas and this can be further reduced by avoiding touching any animals. Post-exposure prophylaxis (both vaccine and rabies immunoglobulin) is readily available.

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Tuberculosis (1)

Tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.

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Typhoid and paratyphoid (0)

Typhoid fever is a bacterial disease, caused by Salmonella typhi. It is transmitted through the ingestion of food or drink contaminated by the faeces or urine of infected people.

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Yellow fever (6)

Yellow fever is an infectious vector-borne disease that is caused by a virus transmitted by the bite of an infected mosquito vector such as Aëdes aegypti. South Africa has a risk of introduction of the disease as the mosquito vector exists in the country.

The South African Department of Health would like to inform you of the amendments to the yellow fever vaccination policy for travellers coming from yellow fever risk countries.

Travellers going to or coming from Zambia, Tanzania, Eritrea, Somalia, Sao Tome and Principe as well as Rwanda  will no longer be required to produce a yellow fever vaccination certificate when in South Africa as these countries have been included on the World Health Organization (WHO) list of countries with low potential for exposure to yellow fever virus.

During the 136th session of the WHO Executive Board meeting, a review of countries with risk of yellow fever transmission and countries requiring yellow fever vaccination was conducted and based on the recommendations of the meeting; all travellers arriving into the country from these countries will NOT be required to produce proof of vaccination against Yellow Fever. This provision is with immediate effect.

In line with the International Health Regulations, 2005 South Africa requires a valid yellow fever certificate from all citizens and non citizens over one year of age:

·         Travelling from a yellow fever risk country; or

·         Having been in transit exceeding 12 hours, through the airport of a country with risk of yellow fever transmission.

The  International  Health  Regulations (2005)  requires  countries  at  risk  of Yellow Fever introduction to employ the following measures:

  1. Obtain vaccination certificates from individua.ls travelling from areas determined by the WHO to be at risk of Yellow Fever transmission. As a result, South Africa implements the following measures for all travellers from Yellow Fever risk countries who are unable to produce a valid yellow fever vaccination certificate at the point of entry:

·         Refuse entry; or

·         Place traveler under quarantine surveillance until their certificate becomes valid, or for a period of not more than six days;

·         Travellers who are in possession of an exemption certificate due to medical reasons will be:

°         Allowed entry;

°         Required to report any fever or other symptoms to the health authorities; and

°         Be placed under quarantine surveillance.

  1. Disinfection of aircraft, ships, tyre casing consignments and other modes of transportation coming from a Yellow Fever risk area.

Definition of a valid Yellow Fever vaccination certificate:

Vaccine should be approved by the WHO and administered at least 10 days before departure to South Africa at a Yellow Fever approved vaccination centre. The vaccine offers protection 10 days after administration and provides lifetime immunity.

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