Travellers must be aware that there is no drug which can guarantee protection in all circumstances. In view of the development and spread of plasmodium falciparum drug resistance, it is necessary that travellers pay attention to personal measures.

The estimated risk of acquiring malaria varies from area to area. It also depends on itinerary and season and type of travel. Travellers who travel to high risk areas but spend their time in cities or resort areas will have limited risk of infection. Tourist staying in air conditioned, screened hotels, and sightseeing during daylight hours will also have minimum risk compared to backpackers, peace corps volunteers and missionaries.

SIGNS AND SYMPTOMS OF MALARIA The incubation period is usually eight to 35 days, but symptoms can develop as early as eight days of exposure in a malaria endemic area. Symptoms are: low grade fever, malase, severe muscle pain, chills. Frequently misdiagnosed and treated as influenza. The symptoms should be investigated as soon a possible.

Malaria can be effectively treated early in the course of the disease, but delays in proper treatment may have serious or even fatal consequences. Make an appointment with your doctor and report any illnesses you may have acquired whilst away. Inform your doctor that you have been in a malaria endemic area.

PERSONAL PROTECTION MEASURES As Malaria transmission occurs primarily between dusk and dawn the hours of darkness are thee greatest risk for acquiring the disease. So in addition to the use of drug prophylaxis, travellers should be advised that from dusk to dawn they should remain in well screened and/or air conditioned areas. For sleeping in rooms not well screened, use mosquito nets carefully tucked under mattress (free from tears). Smear insect repellent (read labels carefully) on any uncovered parts of the body, bearing in mind that the effect may be reduced by sweat. Cover most of the body with clothing of a light colour since dark colours attract mosquitoes.

When discussing malaria prophylaxis with the doctor, mention: All medication you are at present taking; If you have recently taken a course of malaria pills; and If you are pregnant or likely to become so.

Prescriptions for Malaria Prophylaxis are designed for each individual traveller, for the exact number of days or weeks, usually starting prior to arrival in the Malaria endemic area, whilst there and for several weeks after leaving the endemic area. If malaria medication is taken as ordered, there will be no medication left over.

Diana Simons Nursing Supervisor Child Health Programme