Malaria in Zambia

Image

Malaria (malaria)

The risk of malaria is available all year round in areas at risk.
It is recommended to protect against mosquito bites.
It is necessary to take a medication (chemoprophylaxis) before, during and after the trip.

Vaccination

The following vaccines are recommended for all:
Diphtheria, tetanus, poliomyelitis, measles, hepatitis A
Under special conditions, the following vaccines are recommended: yellow fever, hepatitis B, typhoid fever, rabies, cholera

Notes for vaccination against yellow fever:

Who vaccination recommendation:
-Vaccination generally not recommended: for travel to the western and Northwestern provinces;
-Vaccination not recommended: all other regions;
Very low/theoretical risk
(See also information on vaccination against yellow fever of the Swiss CEMV)

For prescription medications and vaccinations, consult a doctor or vaccination Centre. Vaccination against yellow fever can only be carried out by a vaccination Centre and some doctors.

Recommended vaccinations

Systematically:

Vaccinations included in the vaccination schedule to be updated

Adults

Children and adolescents: in particular, all persons 2 years and older, born since 1980, should have received two doses of the trivalent measles-mumps-rubella vaccine. For children, measles vaccine is recommended from the age of 6 months.

Hepatitis A

Children: From the age of 1 year
According to the terms of the stay:
Yellow fever

Vaccine available only in the international vaccination centres.

Vaccination is generally not recommended for travellers to all Northwestern and Western provinces, except in the case of exposure to mosquito bites.

Vaccination is not recommended for all other areas.

NB: A yellow Fever vaccination certificate is required for travellers over the age of one year from countries where there is a risk of transmission of YF and passengers who have stayed more than 12 hours in transit at an airport in a country where there is a risk of Tran Smission of yellow fever.

Vaccination regimen: 1 injection to be made at least 10 days before departure.

Children: from the age of 9 months (between 6 and 9 months, only in special circumstances.)

Duration of validity: lifetime.

Indeed, following a decision by the World Health Organization, the obligation of decennial recalls has been abolished. However, according to the opinion of the High Council of Public Health, recalls of yellow fever vaccination remain recommended for:

Children vaccinated before the age of 2: A second dose from the age of 6 years in the event of a new trip to the yellow-endemic zone;
Women who are first-vaccinated during pregnancy, persons living with HIV and those immunocompromised vaccinated under the conditions specified in the HCSP report: A second dose 10 years later;
People whose vaccination against yellow fever is more than 10 years old: A second dose in the event of a reported epidemic in the country visited.

Hepatitis B

For long or repeated stays.

Two injections spaced for one month.

Single reminder 6 months later.

Where immunity is to be rapidly acquired (in the event of imminent departure), an accelerated regimen with three close doses and a fourth dose 1 year later may be used only in adults.
Meningococcal meningitis

In case of prolonged stay in close contact with the local population, or in times of epidemic.
Rage

In case of an extended stay, in an isolated situation.

Children: As soon as they are of walking age.
Typhoid

In case of prolonged stay or in precarious hygiene conditions.

Children: From the age of 2 years
Prevention of malaria

Year-round Transmission throughout the country including Lusaka.
Prevention:

Chemoprophylaxis by Atovaquone/Proguanil or Doxycycline or mefloquine mosquito bites Protection

In the event of a fever occurring during the stay or in the months following the return, a doctor should be consulted as soon as possible.

 

Health and Safety Zambia

General Tips before you leave

We will tell you about them here, but there may be new instructions due to the emergence of a new problem. Same thing with respect to security. It is important to learn about what is happening in the country before you go to discover it.

-Remember to check that you have purchased insurance that includes health repatriation. If this is not the case, do it!

Health

Vaccinations

-Diphtheria-tetanus-poliomyelitis: update of recommended vaccination.

-typhoid fever, viral hepatitis A and B, Rabies: vaccination recommended in some cases (hygiene conditions, length of stay…).

-Measles: The updating of this vaccination may be necessary, especially in children.

-Yellow fever: A vaccination certificate is required for persons arriving from a country or experiencing yellow fever. This vaccination must be done at least six days before the entry into Zambia.

-Bacterial meningitis A + C + Y + W135: recommended vaccination.
Health risks

-Malaria, chikungunya, dengue, yellow fever. Protecting yourself from mosquito bites requires protective measures (sprays, creams, electric diffusers, mosquito nets…). The Palu requires a drug treatment adapted to each individual: Before departure, ask your doctor for advice.

-Traveller’s diarrhea, cholera. Drinking bottled water is one of the essential tips to avoid being reached. Also be sure to cook the food you eat and wash your hands regularly. During the rainy season (November to April), cholera epidemics are frequent, particularly in the mining and Lusaka regions.

-HIV – AIDS: High prevalence rate, estimated at 14.3%.

Security

Areas to avoid, precautions to be taken

-Border areas: armed groups cross the border between Zambia and the Democratic Republic of the Congo. Avoid this area as much as possible. Be very vigilant in the north-west province, bordering on the DRC and Angola: War explosives are not yet eliminated. Do not move out of the main roads and especially not at night.

-Deserted areas between Livingstone and Victoria falls: Tourist attacks have been reported.

-Theft and aggression: one of the main precautions to be taken is to avoid getting around at night. By car, always keep its doors locked and its windows closed. Finally, simple measure of common sense: Do not expose your valuables.

-Tensions during an election period. Avoid rallies.

Once these precautions are taken, do not be alarmed too much. Overall, Zambia remains a calm country.

For more up-to-date information, check out the travel tips from the Department of Foreign Affairs.

Malaria – main facts

Main facts

Malaria is a potentially deadly disease caused by parasitic infections transmitted to humans by infected female mosquito bites.
It is estimated that in 2016, 216 million cases of malaria were in 91 countries, or 5 million more cases than in 2015.
Malaria resulted in 445 000 deaths in 2016, a figure similar to that of 2015 (446 000).
The African region of who supports a disproportionate share of the global burden of malaria. In 2016, 90% of malaria cases and 91% of deaths due to this disease occurred in this region.
In 2016, funding for combating and eliminating malaria was estimated at 2.7 billion (US $) in total. The contributions of the Governments of the endemic countries reached 800 million million (US $), or 31% of the funding.

Malaria is caused by parasites of the genus Plasmodium transmitted to humans by bites of infected female Anopheles mosquitoes, known as “malaria vectors”. There are 5 types of parasite species responsible for malaria in humans, of which 2 – Plasmodium falciparum and P. Vivax are the most dangerous.

Plasmodium falciparum is the most widespread malaria parasite on the African continent. He is responsible for most of the deadly cases in the world.
P. vivax is the predominant parasite outside of Africa.

Symptoms

Malaria is an acute febrile illness. In an unimmunized subject, symptoms usually occur after 10 to 15 days after the infecting mosquito bites. The first symptoms – fever, headache and shivering – can be moderate and difficult to attribute to malaria. If not treated within 24 hours, Plasmodium falciparum malaria can evolve into a severe, often fatal disease.

Severely affected children frequently develop one or more of the following symptoms: severe anemia, respiratory distress following metabolic acidosis or cerebral malaria. In adults, a multi-organic attack is also frequently observed. In endemic areas, people can sometimes be partially immunized, and there may be asymptomatic infections.
Exposed Populations

In 2016, nearly half of the world’s population was exposed to the risk of acquiring malaria. Most cases of malaria and deaths due to this disease occur in sub-Saharan Africa. However, the WHO regions of Southeast Asia, the Americas and Eastern Méditérannnée are also affected. In 2016, 91 countries were confronted with continuous transmission of malaria.

Some groups of the population are at a much higher risk than others to get malaria and to be severely affected: infants, children under the age of 5, pregnant women, people with HIV or AIDS, Non-immunized migrants, itinerant populations and travellers. National malaria control programmes should take specific measures to protect these malaria groups, taking into account their situation.
Burden of disease

According to the latest report on World Malaria, published in November 2017, there were 216 million cases of malaria in 2016, compared to 211 million in 2015. The number of deaths due to malaria in 2016 is estimated at 445 000, a figure similar to that of the previous year (446 000).

The WHO region of Africa supports a disproportionate share of the global burden of malaria. In 2016, 90% of malaria cases and 91% of deaths due to this disease occurred in this region. 80% of the burden of malaria-related morbidity weighed over 15 countries – all in sub-Saharan Africa, except India.

In areas where malaria transmission is intense, children under 5 years of age are particularly vulnerable to infection, disease and death; More than two-thirds (70%) of deaths due to malaria occur in this age group.

The number of deaths recorded among children under 5 years of age increased from 440 000 in 2010 to 285 000 in 2016. However, malaria still remains a major factor in mortality among children under the age of five and a child dies every two minutes.

Malaria – transmission

Transmission

In most cases, malaria is transmitted by female Anopheles bites. There are more than 400 different mosquito species of Anopheles mosquitoes, of which about 30 are very important vectors of malaria. All important malaria vector species sting between dusk and dawn. The intensity of the transmission depends on factors related to the parasite, the vector, the human host and the environment.

The Anopheles lay their eggs in the water. These eggs hatch into larvae and then become adult mosquitoes. Female mosquitoes are looking for a blood meal to feed their eggs. Each species has its own preferences; Some for example prefer shallow freshwater such as puddles and the footprints left by Animal hoofs, which are abundant during the rainy season in tropical countries.

Transmission is more intense in places where mosquito species have a relatively long lifespan (allowing the parasite to complete its development cycle within the mosquito) and instead sting human beings rather than animals. The long life span and the strong human preference of African vector species explain that nearly 90% of malaria cases occur in Africa.

The transmission also depends on the climatic conditions that can influence the abundance and survival of mosquitoes, such as the precipitation regime, temperature and humidity. In many places, the transmission is seasonal with a peak during or just after the rainy season.

Epidemics of malaria can occur when climate and other conditions suddenly encourage transmission in areas where populations are little or not immune. They may also occur when low-immunized people move to areas of intense transmission, for example to find work or as refugees.

Human immunity is another important factor, especially in adults in areas of moderate to intense transmission. Immunity develops after years of exposure and, although it never confers total protection, it reduces the risk that malaria infection will cause severe disorders.

This is why most malaria deaths in Africa occur in young children, while in low-transmission areas and where the population is poorly immunized, all age groups are exposed.

Malaria – elimination

Elimination

Disposal is defined as the interruption of local transmission of a well-specified Plasmodium species in a geographical area defined as a result of deliberate efforts. Continual measures are required to avoid the recovery of the transmission. (Certification of the elimination of malaria in one country implies that local transmission has been interrupted for all species of Plasmodium parasita humans).

The eradication of malaria is defined as the permanent reduction to zero of the global incidence of infection caused by human malaria pests as a result of deliberate activities. There is no longer a need for intervention once the eradication has been achieved.

The pace of progress in a particular country depends on the robustness of the national health system, the level of investment in malaria control and a number of other factors, such as biological determinants, the environment and Social, demographic, political and economic realities of the country in question.

In countries with moderate to high malaria transmission, national malaria control programmes are aimed at minimizing the number of cases and deaths due to this disease.

When countries approach elimination, enhanced surveillance systems contribute to the detection, treatment and notification of each infection in the National Malaria Registry. Patients diagnosed with malaria should be treated quickly with effective antimalarial drugs in order to protect their own health, but also to avoid further transmission of the disease in the community.

Countries that have managed for at least 3 consecutive years to zero local malaria cases meet the requirements to ask who to certify the elimination of malaria. In recent years, the Director-General of WHO has certified that 8 countries have eliminated malaria: the United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Maldives (2015), Sri Lanka (2016) and Kyrgyzstan (2016 ) and Paraguay (2018).

The WHO Framework for Malaria Elimination (2017) provides a comprehensive set of tools and strategies for achieving and maintaining elimination.