Malaria Alert: South Africans Urged to Stay Vigilant Over April Holidays

As South Africans prepare to take advantage of April’s string of public holidays, the National Department of Health (NDoH) is urging the public to exercise caution following a slight rise in malaria cases. The warning is especially important for those travelling to or living in Limpopo, Mpumalanga, and KwaZulu-Natal—where malaria is more common.

While specific figures are still being confirmed, health authorities are closely monitoring the situation due to simultaneous outbreaks across several neighbouring SADC countries, including Botswana, Eswatini, Namibia, Mozambique, and Zimbabwe. This regional spike increases the likelihood of cross-border infections, particularly with more people on the move during the holiday period.

Furthermore, the NDoH has ramped up its efforts to contain the situation, advising healthcare professionals in both high-risk and lower-risk areas to be alert. “Doctors are being urged to consider malaria in patients with flu-like symptoms and to report confirmed cases immediately,” said the department, adding that early diagnosis can save lives and reduce the spread of the disease.

Healthcare workers have also been reminded to ask patients about recent travel history—especially if they’ve been in high-risk zones—and to repeat malaria tests if symptoms persist, even after an initial negative result.

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Where the Risk is Highest

In South Africa, malaria is mainly transmitted in specific districts within Limpopo, Mpumalanga, and KwaZulu-Natal. These areas are considered malaria hotspots due to environmental conditions, cross-border movement, and local transmission patterns.

Limpopo Province

Vhembe and Mopani Districts carry the heaviest burden:

• Musina: A border town with Zimbabwe, it has long been a malaria hotspot. Its climate and seasonal rainfall, along with a high volume of cross-border trade, make it vulnerable.
• Thohoyandou: High density, poor infrastructure, and proximity to Mozambique and Zimbabwe contribute to ongoing malaria issues.
• Giyani: Agricultural activities and frequent flooding provide ideal breeding grounds for mosquitoes.
• Phalaborwa: Proximity to the Kruger National Park and a humid climate raise transmission risk, particularly among tourists.
• Lephalale: An emerging hotspot along the Lephalala River. Wetlands and migrant labourers contribute to new infections.

Mpumalanga Province

Ehlanzeni District is the epicentre here:

• Bushbuckridge: A rural area plagued by poor infrastructure and healthcare access. Outbreaks have spiked during rainy seasons.
• Nkomazi (Komatipoort and Malelane): Located on the Mozambique border and near the Kruger Park, this area sees regular imported cases.
• Thulamahashe: Surrounded by irrigation and farmland, it remains a steady source of cases.

KwaZulu-Natal Province

uMkhanyakude District is the main area of concern:

• Jozini: Located near Mozambique, it faces ongoing low-level transmission. Delayed diagnosis remains a major issue.
• Mtubatuba: Its coastal wetlands and popular tourist destinations like iSimangaliso Wetland Park contribute to imported cases.
• Hlabisa and Manguzi: These rural towns continue to experience persistent cases due to cross-border movement and environmental conditions.

Spotting the Culprit: The Anopheles Mosquito

Anopheles mosquitoes, responsible for spreading malaria, have unique traits:

• They bite at night (6 PM to 6 AM)
• They rest indoors after feeding
• They breed in clean, sunlit water like ponds and rivers
• They rest at an angle, unlike other species
• They have speckled wings and banded legs

Recognising these characteristics helps health officials and residents better manage control efforts.

The Danger of Untreated Malaria

If left untreated, malaria can quickly become life-threatening. The disease caused by Plasmodium falciparum—South Africa’s most common strain—can lead to:

• Severe complications like cerebral malaria, kidney failure, and respiratory distress
• Organ damage due to the parasite multiplying in red blood cells
• Higher transmission rates, as infected people serve as a source for further mosquito infection
• Serious risks for vulnerable groups, including pregnant women and young children
• Rapid symptom worsening within 24–48 hours if not treated with artemisinin-based combination therapies (ACTs)

How to Protect Yourself

To reduce your risk, especially if you’re in or travelling to high-risk areas, the NDoH recommends the following:

• Use insecticide-treated bed nets (ITNs) every night
• Allow indoor residual spraying (IRS) teams access to your home
• Close windows and doors from dusk to dawn
• Apply mosquito repellent with DEET or picaridin, especially in the evenings
• Repair or install fine-mesh window and door screens
• Eliminate stagnant water around your home to prevent mosquito breeding
• Use fans or air conditioning, and seal cracks and gaps in your house

For travellers, especially over the April holidays, it’s critical to:

• Take malaria prophylaxis before, during, and after your trip
• Mention your travel history when visiting a healthcare provider
• Seek medical help immediately if you develop fever, chills, or flu-like symptoms

As malaria cases rise in Limpopo, Mpumalanga, and KwaZulu-Natal, and regional outbreaks grow across neighbouring countries, South Africans are encouraged to remain cautious. With the right preventative steps and prompt treatment, this deadly—but preventable—disease can be kept in check.

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