Words and pictures by Grant Spolander.
Malaria – how to prevent it from killing you if you get it.
A few months back I was sitting around a breakfast table with Kingsley Holgate, who was describing a malaria attack. Squinting his eyes and holding his back in a show of pain, he said, “You’ll feel it in your lower back, as if your kidneys are about to burst. It’s a lot like having the flu – fever, cold sweats and severe muscle pain – but without the sore throat and blocked nose.”
At the time, I was travelling with Kingsley on his latest Great African Rift Valley Expedition, and we were staying in a small town called Rukungiri, in the southern part of Uganda.
Several days later I was back in Cape Town, sitting in front of my PC. It was a Monday morning and I was knackered after the weekend – my wife was away, and had left me at home alone with our two-year-old. A few of my colleagues commented on my colour, but I thought nothing of it.
By 10h00 it felt like someone had slipped Rohypnol into my morning tea, as I was so tired I could barely keep my eyes open. Before I knew it, I was clutching my lower back, squinting my eyes and trying to massage the pain away. It was at that point that I remembered Kingsley’s words about how a malaria attack felt, but I wasn’t totally convinced: a flu bug was doing the rounds at the time so I figured it was my turn. It was odd, though, that my throat wasn’t sore and my nose wasn’t blocked.
My condition worsened every 15 minutes, and by late morning I could barely move; my back was killing me and all I wanted to do was sleep. At midday I realised it wasn’t the flu, as things were moving way too fast for that, and so a short while later I was sitting in a doctor’s room giving blood. These days you can purchase a malaria self-diagnosis kit for approximately R40 (ask your local pharmacist). It’s a very basic setup which includes a malaria test strip and a needle to prick your finger. Unfortunately, these kits aren’t accurate and should never take the place of a proper blood test, especially if the results come back negative.
In fact, the same goes for a laboratory blood test: these too should be viewed with scepticism. If the symptoms persist, and all the signs point towards malaria, you should continue to send blood samples away until a positive result is reached, or until the symptoms have stopped altogether.
As timing is critical, and every hour can make a huge difference with malaria, you really want to start treatment as soon as possible. In my case, I had been feeling fine the day before, that morning I had felt a little run down, and by midday I was ready to meet my maker. I started treatment that evening, and by the following day I was doing much, much better.
There are a few treatment drugs to choose from, and these days doctors often prescribe Coartem, a tablet-form medication which is very effective in treating malaria. However, it must be taken correctly – at equal time intervals, and completing the course.
If you start treatment early – before the parasite has exponentially multiplied – you have a very good chance of a full recovery. However, the biggest problem with malaria is its diagnosis – few u r b a n doctors deal with malaria on a regular basis so the illness is seldom on their diagnosis radar. Despite having full medical a c c e s s , tourists and travellers die from malaria frequently; this isn’t a poor man’s parasite. Malaria kills indiscriminately. Again, much of the problem stems from the fact that people don’t seek medical attention when they notice fatigue, fever, cold sweats, headache, nausea and muscle pain; instead, they ascribe the symptoms to flu or a viral attack. Unfortunately, when it comes to malaria you cannot afford to wait for the symptoms to get worse. Quite often the illness will come in waves: one minute you’ll feel sick and the next you’ll be on the mend. This does not mean that you’re getting better; a blood test should still be conducted.
Malaria parasites come in various forms, but in Africa the most common strain is Plasmodium falciparum, one of the most dangerous strains around – a people-killer. According to the World Health Organisation, more than one million people worldwide die from malaria each year. Several other strains are not as deadly, but once contracted, these parasites can remain dormant in your liver for many, many years to come, and occasionally they resurface and cause a repeat attack years later.
In short, there are only two rules to abide by when dealing with malaria: One, if you’re feeling ill after visiting a malaria area, consult your physician and insist on a blood test. Two, stick to the treatment’s directions by taking the drug at the right intervals and always finishing the course!
It’s been said that new malaria strains are rapidly developing. A contributing reason for this is people not finishing the treatment’s course; as a result, the parasite isn’t fully terminated and is then able to adapt to the medication, forming a new, drug-resistant strain.
TALK TO THE PROFESSIONALS For more information on malaria, visit www.malaria.com or contact your local Medi-Travel International Centre on:
Cape Town 021 419 1888
Johannesburg 011 706 7710
Pietermaritzburg 033 342 9348
Pretoria 012 348 5245
Nelspruit 013 759 0500
Vereeniging 016 440 5717