My first response to this one would be no. Probably not, as long as you take the necessary precautions (see below).
We've lived in East Africa for 12 years now and no one in our family of 5 has had malaria yet....(touch wood). Four of those years were spent in the highly malarial city of Dar es Salaam in Tanzania, during which time I had two babies.
Obviously I was concerned about malaria (I had never been to Africa before) and I may not be an expert, but I was lucky enough to attend a lecture by a malaria guru (somebody who was studying the disease) early on in our stay there. His words and advice have stayed with me ever since. This is what I learned.
About the Mosquitoes
1. Not all mosquitoes carry malaria. Malaria carrying mosquitoes are called Anopheles mosquitoes.
2. Anopheles mosquitoes are female and their back end sticks up, whereas other mosquitoes back ends point down. (Okay, this is fairly irrelevant since you rarely get close enough to a mossie to see this).
3. Anopheles mosquitoes that carry malaria are sick. Being sick makes them lazy. They generally hide in dark places during the day (cupboards, dark rooms etc), then emerge between 10pm and 6am to do their biting.
4. Mosquitoes breed in standing/stagnant water. After rainy season, if there is any near your house, try to get rid of it.
What does it actually feel like to have Malaria?
The disease attacks your red blood cells. You get a high fever, nausea. Hot and cold chills but it comes and goes in waves. There can be vomiting and diarrhoea.
How long does it take to get it and how do I test for it?
The incubation period for malaria stretches from 7 to 21 days, which is why your doctor will tell you to continue taking anti-malarials for up to a month after you have travelled.
Testing is a simple thumb prick blood test which can be read in 10 minutes, but please note:
• But if you are in a non-malarial country, the testing process can take far longer.
• The test can read negative. The nature of malaria is that it hits you in waves. The test generally only reads positive if you are experiencing a fever at that moment (caused by the intermittent bursting of red blood cells). If in doubt, go back and do another test, or start taking the treatment anyway.
Am I immune to Malaria if I take anti-malarials/prophylactics? NO!
NO!! Anti-malarials comprise of the exact same treatment for malaria itself. If you get malaria while taking prophylactics, then you are effectively already giving yourself a mild dose of the treatment.
This means that symptoms are dampened and you might feel that you are just experiencing a bout of flu.
It's very dangerous to ignore these types of symptoms when you have left a malarial country because testing and diagnosis can take longer. If you have travelled to a malarial place, then experience fevers afterwards, always tell your doctor to test for malaria.
In a malarial country, you will have access to the best, fasted, most accurate testing (blood test can take 10 minutes). The most vulnerable people are those travellers who are uninformed about the disease, then travel home, contract malaria and assume it is a common cold. Because malaria is not common in their country of origin, they may struggle to get tested or diagnosed, be put on doctors/hospital waiting lists etc. I actually know of a guy from Kenya who contracted malaria when in England. His mum put him straight back on a flight to Kenya because she figured he would get treated faster this way.
Prevention
There are various steps you can take to prevent being bitten by a malarial mosquito. If you are moving to a malarial country then you will actually be best placed to make sure all the steps are followed.
1. USE TREATED MOSQUITO NETS
This was the single most important piece of advice from our malaria expert.
Although the treatment is odourless when dry and absolutely harmless to humans (babies can even suck a net with the treatment on it) the Anopheles mosquito cannot stand the stuff. If you have a treated net in the room, the anopheles mosquito will not go in. A couple of nets, the Anopheles mosquito will not enter that floor of the house, if it's a bungalow, they may well not go inside at all. Sadly, the treatment does not deter all types of mosquito, just the malaria carrying ones but at least you can rest assured that if a mossie gets into your net then it won't be an Anopheles.
In those days, I used to treat my own nets using a product called 'Ngao' in Tanzania or 'Power Tab' in Kenya. It's a simple tablet that you dissolve in water. A set of instructions comes in picture form and the net treatment is effective for at least 3 months.
What happens if your mosquito nets are all fixed semi-permanently in place?
You can also dissolve the tablet in the correct amount of water (enough to fill a small soda bottle), then put it into a hand held spray container (like an old disinfectant sprayer), then spray your nets, curtains and window mesh or gauze's.
If you are staying in a hotel, carry a treated net with you then just drape it over a door or chair in each bedroom to ensure that Anopheles mosquitoes don't do in.
These days, you can buy mosquito nets that are already treated for up to two years.
2. COVER UP IN THE EVENINGS
It may be boring, but it's a good idea to cover up in the evenings, even though it's hot. Long, loose fitting cotton trousers and long sleeved kaftan tops are good too. If you do want to show some flesh, just make sure you slather yourself in mosquito repellent. Many people recommend products containing deet, but these are quite toxic. I remember being a bit horrified about the fact that the deet made the dye from my flip flops bleed into my skin! There are loads of great herbal products and oils on the market too.
When living in Dar es Salaam, my husband and I actually used to wear socks because the relief of not being bitten around the ankles in the evening far outweighed the fashion statement.
3. DROP NETS AND SPRAY EARLY EVENING
As a rule of thumb, it is worth dropping your nets down around your beds by 5pm. Then close all doors and windows and spray with an insect killer (Doom is a popular one in Kenya), focus on spraying inside cupboards and under the bed, dark places where mossies like to hide. Then leave the room for at least 10 minutes because the spray is pretty toxic.
Travel with malaria treatment. In East Africa you can get most medicines from behind the counter without prescription. There's no harm in buying a malaria treatment kit (normally a combination of 2 drugs, one fast and one slower acting), then travelling with it. In an emergency, if you suspect you or any one of your family has contracted malaria then start taking the course of drugs.
