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World Malaria Day: What travellers to and within India must know about malaria

Travellers to malaria prone areas should take one anti-malaria tablet daily, starting one or two days before travel and continuing till a week after return.

health Updated: May 05, 2017 10:50 IST
Sanchita Sharma
malaria

A woman walks past camels as a foreign tourist takes pictures at the Pushkar fair in Pushkar, Rajasthan. Pushkar, located on the banks of Pushkar Lake, is a popular Hindu pilgrimage spot that is also frequented by foreign tourists for its annual cattle fair and camel races.(HT FILE PHOTO)

If you’re planning a tropical holiday in a warm and balmy India over the next few months, you need keep the mosquito menace malaria in mind while packing.

Half the world’s population lives in malaria-infested areas, with south Asia, south-east Asia and Africa being the worst. In 2015, malaria sickened 212 million persons and caused 429,000 deaths, estimates the World Health Organisation.

Malaria infection occurs throughout the year in India, but peaks between July and October when the weather is warm and wet. As many as 1.06 million people have been infected by the disease and 242 have died of it.

Which mosquitoes spread malaria?

The Anopheles mosquito, which bites between dusk and dawn, spreads the infection caused by single-celled Plasmodium parasites, with P. falciparum and P. vivax between them causing most infections in India.

P. Falciparum, which accounts for 99% deaths worldwide, has become the dominant malaria-causing parasite in India.

The An. culicifacies is the principal vector of rural malaria and accounts for 60-70% of annual cases, while the An. stephensi is dominant in urban areas. Irrespective of the type of mosquito spreading infection, the disease remains the same.

How does malaria spread?

Parasites cause infection between persons through mosquito bites, which it uses to invade the liver and then the red blood cells. At first, the symptoms are generic—fever, headache, sweats, chills and vomiting—and at this stage, the immune system usually manages to control the infection. In severe malaria, the parasite disrupts blood supply to the vital organs, including the brain, causing seizures and death.

What are the symptoms?

Malaria is marked by high fever with chills followed by profuse sweating, occurring at intervals of 48 to 72 hours. Since the symptoms are very similar to influenza, misdiagnosis of malaria is common and most people begin treatment a week or so after they fall ill.

Symptoms include:

* Fever (100° to 102° F) and chills

* Headache

* Nausea

* Muscle pains

* Fatigue

Which are the worst-hit states in India?

In India, 80% of malaria cases occur among 20% of its population living in the 200 high-risk districts of Andhra Pradesh, Chhattisgarh, Gujarat, Jharkhand, Karnataka, Madhya Pradesh, Maharashtra, Odisha, West Bengal and the seven north-eastern states. With only fewer than half of those infected reaching a clinic or hospital, the cases and deaths are much higher than recorded.

How do I prevent malaria?

Anti-malarial tablets containing a combination of atovaquone and proguanil is used to prevent and treat P Falciparum malaria, which accounts for 99% deaths worldwide. Half of all malaria cases in India are caused by the P Falciparum parasite.

Travellers to malaria prone areas should take one tablet daily, starting one or two days before travel and continuing till a week after return. Atovaquone and proguanil tablets are available in two combination strengths: 250/100 mg (adults) and 62.5/25 mg (paediatric).

How is malaria treated?

India provides the WHO-approved combination of a fast-acting combination called artemisinin combination therapy (ACT) in public hospitals and clinics free to everyone who needs it.

How can I protect myself?

* Cover up and wear loose clothes with long sleeves and bottoms that cover you up

* Use mechanical barriers such as bed nets and meshes and screens on windows and doors

* Repellents such as DEET (N,N-diethyl-3-methylbenzamide), permethrin and citronella keep mosquitoes away

* Use insecticides such as aerosol sprays with allethrin, resmethrin, malathion or carbaryl methoprene

* Mechanical mosquito zappers work

* Insect traps that emit a plume of CO2, sometimes mixed with octonol, attract and trap insects

* Destroy potential breeding sites such as old tires, desert-coolers, birdbaths, pots, etc. where water can accumulate

* Cull excess vegetation that could become a resting place for mosquitoes