The number of estimated malaria cases in 2021 was 247 million.  The WHO African Region carries a disproportionately high share of the global malaria burden.  In 2021, the Region was home to 95% of malaria cases and 96% of malaria deaths.  Children under 5 accounted for about 80% of all malaria deaths in the Region.

Imported and odyssean malaria

Imported malaria is malaria diagnosed in a country other than that in which it was acquired.  Runway malaria and migrant workers are examples of imported malaria.

Odyssean malaria is malaria acquired in a non-malarious area from the bite of an imported mosquito.  Examples of odyssean malaria include airport malaria, baggage malaria, luggage malaria, suitcase malaria, container malaria, port malaria, taxi malaria and minibus malaria.  These terms are based on the various modes of passive transport used by infected mosquitoes.

Imported malaria and odyssean malaria are important because of the high incidence of complications and mortality often associated with them.

Odyssean malaria in South Africa

Nowadays it is easier to travel than ever before and humans are able to cover vast distances in a short period.  This also applies to the infective mosquito that “hitched a ride” from an endemic area to a non-malarious area.

The contracting of malaria outside endemic areas is unexpected and this delays diagnosis and treatment.  It is therefore disproportionately associated with severe illness or a fatal outcome.  Gauteng has a substantial number of malaria deaths for a province where malaria is not endemic.  This is because the disease is misdiagnosed in several patients who did not travel.

The key to reducing the complications and mortality related to malaria is early recognition and treatment.  It is therefore crucial that when a patient presents with a fever, to consider malaria.

Summer is malaria season in South Africa

As we enter summer, malaria cases in South Africa are expected to increase.  This is due to higher temperatures and increased rainfall in the malaria transmission areas.  During the upcoming holiday season, many people will travel to transmission areas, both internally and outside the country borders, exposing them to malaria.

In the last few years, there has been some expansion of low or very low malaria transmission to some districts previously regarded as non-malaria areas in South Africa.  People who are planning to travel are urged to take adequate measures to protect themselves from malaria.

All travellers returning from malaria transmission areas, including very low risk ones, should report ’flu-like illness (headache, fever, chills, fatigue, muscle and joint pain) that occurs up to three weeks after first potential exposure, in case it is malaria.  Children with malaria may have very nonspecific signs (fever, loss of appetite, vomiting).  A malaria risk map, FAQs and further information on prevention are available on the NICD website.

Increases in imported and odyssean malaria cases are also anticipated during and after the festive season holidays.  All healthcare practitioners are encouraged to consider malaria as a differential diagnosis in patients presenting with unexplained fever (>38°C) and progressive ‘flu-like’ illness, even in the absence of a travel history to a malaria-endemic region.

Screen for malaria with a rapid diagnostic screening test

The period between the bite of an infected mosquito and the start of illness is usually 7 to 21 days.  Anti-malaria (prophylactic) medicine can lengthen the period.  It is extremely important that all suspected cases of malaria receive urgent medical attention.

A laboratory test confirms if malaria parasites are in your blood, however, this test takes time.  Due to the urgency of obtaining a diagnosis, a screening test for malaria is helpful.  This screening test does not require experienced personnel or equipment.  The test results are immediately available.

Malaria rapid diagnostic screening tests (RDTs) detect specific antigens produced by the parasites in the blood of people infected with malaria.  Some malaria RDTs detect only one species (Plasmodium falciparum), while others, for example U-Test Malaria, identify multiple species (Plasmodium falciparum, vivax, malaria and ovale).

RDTs are relatively simple to perform and interpret.  A finger-prick provides the blood needed for the test.  It enables a reliable detection of malaria infections including in remote areas.  Therefore, you can do the test anywhere and at any time.  A doctor should confirm a positive result.  Malaria is also a notifiable disease where a positive test result should be reported.  It is important to remember that due to the long incubation period (7 to 21 days) before the start of the illness, that a negative test result does not completely rule out the possibility of malaria.  If the symptoms continue, repeat the test after a few days.

Malaria: early detection, your best protection.  U-Test Malaria is fast and easy to use.  It gives a result within 15 to 30 minutes.  The single test kit includes all the items needed to perform the test.  It includes a finger pricker (lancet) and a sterile swab.