Malaria in Tanzania
Malaria if you live in Tanzania
Tanzania has the third largest population at risk of malaria in Africa: over 90% of population live in areas where there is malaria. Each year, 10 to 12 million people contract malaria in Tanzania and 80,000 die from the disease, most of them of them children.
As seen in the map, Malaria risk is highest in the Kagera Region on the western shore of Lake Victoria and lowest in the Arusha Region. Fortunately, malaria cases have dropped significantly over the last decade. In the last years, the number of children dying from malaria has halved.
However, change of climate and extensive movement of people has complicated the fight as mosquitoes are now found in places previously free of malaria.
What is malaria?
Malaria is a disease transmitted by a mosquito. The mosquito bite introduces parasites from the mosquito’s saliva into a person’s blood. Then, parasites travel to the liver where they mature and reproduce. Only some mosquitoes carry malaria. The ones that do are called “Anopheles”. They bite at dusk and during the night. Mosquitoes must have been infected through a previous blood meal taken from an infected person.
Malaria is not transmitted from person to person, except during pregnancy from mother to child.
People exposed to malaria develop partial immunity, but no one becomes fully immune to malaria. Also, this partial inmunity can dissappear over the years of you live in areas where there are no malaria. There is no vaccine yet, although scientists are working on it.
There are currently no vaccines against malaria you can buy. One research vaccine (RTS, S/AS01) against the most common type of malaria parasite in Tanzania is the most advanced. This vaccine has been evaluated in a large clinical trial in 7 countries in Africa (including Tanzania) and has shown very promising results among children. It is expected that it could be rolled out as early as 2017.
The initial symptoms of malaria are similar to flu symptoms: headache, fever, shivering, joint pain, vomiting and convulsions. The classic symptom of malaria is paroxysm—sudden coldness followed by shivering and then fever and sweating, occurring every two days or three days, or a less pronounced and almost continuous fever. These symptoms typically begin 8–25 days after being biten by the mosquito.
Diagnosis and treatment
Early diagnosis of malaria reduces disease and prevents deaths. The best available treatment is artemisinin-based combination therapy (ACT).
It is recommended that all cases of suspected malaria are confirmed using parasite-based diagnostic testing (either microscopy or rapid diagnostic test) before administering treatment.
How to protect yourself against Malaria
You should try to avoid moquito bites, specially during dark. To do this you can:
- Use mosquito nets to help keep mosquitoes away from you. The preferred method is to hang a large “bed net” above the center of a bed such that it drapes down and covers the bed completely.The nets are not a perfect barrier, so they are often treated with an insecticide designed to kill the mosquito before it has time to search for a way past the net. Insecticide-treated nets are twice as effective and offer greater than 70% protection compared with no net. For maximum effectiveness, the nets should be re-impregnated with insecticide every six months.
- Spray insecticides on the interior walls of your home. After feeding, many mosquito species rest on a nearby surface while digesting the bloodmeal, so if the walls of dwellings have been coated with insecticides, the resting mosquitos will be killed before they can bite another victim, transferring the malaria parasite.
- After sunset cover up with clothing such as long sleeves and long trousers and use insect repellents on exposed skin.
Video: mZinduka malaria anthem featuring popular artists including Linah, Recho, Banarba, Amini, Mwasiti and Madee. The lyrics promote malaria awareness and prevention. A Malaria No More initiative.
Want to test what do you know about malaria? Take the quiz and find out!
Video: The End Game looks at a range of solutions being pioneered in Tanzania in the battle against malaria.
Malaria if you travel to Tanzania
Malaria risk is high throughout the country except in high altitude mountains over 2000m (including Ngorongoro crater rim, Mt Kilimanjaro and parts of the Eastern Arc Mountains). Most safari parks are high-risk zones. The highest risk is in rural areas.
- Malaria precautions are essential in all areas below 1800m, all year round.
- Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net.
- Check with your doctor about suitable antimalarial tablets: Atovaquone/proguanil OR doxycycline OR mefloquine is usually recommended.
- If travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby treatment may be considered.
- If you have been travelling in a malarious area and develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.
The information for malaria prophylaxis outlined here is intended as a guideline only and may differ according to where you live, your health status, age, trip itinerary, type of travel, and length of stay. Seek further advice from your physician or travel health clinic for the malaria prophylactic regimen most appropriate to your needs.
Either atovaquone/proguanil (Malarone), or mefloquine (Lariam) or doxycycline may be given. Atovaquone/proguanil (Malarone) is a combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure. Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare. Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting, dizziness, insomnia, and nightmares. Rarely, severe reactions occur, including depression, anxiety, psychosis, hallucinations, and seizures. Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine. Those taking mefloquine (Lariam) should read the Lariam Medication Guide (PDF). Doxycycline is effective, but may cause an exaggerated sunburn reaction, which limits its usefulness in the tropics.
Long-term travelers who may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours.