Ref : www.mozambiquehappenings.co.za

This page is a guide line only and all travelers are strongly recommended to visit either their private doctor or a health clinic, experienced in travel, 4-8 weeks before departure for further medical advice.

Malaria occurs within the Lowveld areas of Mpumalanga, right through the year.
Malaria is spread by the Anopheles mosquito, so preventing yourself being bitten is of paramount importance.
Mosquito nets and repellents are strongly recommended after sundown.
Try to avoid being bitten by wearing clothing that covers the arms,legs and ankles and use repellant' - (See DEET below) - on the exposed parts of your body as well as sleeping under treated mosquito nets.
When in malaria areas use effective DEET insect repellents (containing Diethyltoluamide).
Try and ensure that the doors and windows of your accommodation are screened against mosquitoes and try and keep them closed, especially before dusk. Having a fan or air-conditioner on at night will keep mosquito activity down to a minimum.

Malaria prophylaxis is recommended for all travelers to Mpumalanga Lowveld.
The three most commonly used ones are;
1.)Mefloquine (Lariam);
2.)Atovaquone/proguanil (Malarone)(PDF);
3.)Doxycycline.

1.)Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure.
Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting, dizziness, insomnia, and nightmares.
Other reactions can occur, including depression,anxiety, psychosis, hallucinations, and seizures.
Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine.
Those taking mefloquine (Lariam) should read the Lariam Medication Guide and possibly conduct tests before they depart.

2.) (PDF). Atovaquone/proguanil (Malarone) is a recently approved combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure.
Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare.

3.)Doxycycline is effective, but may cause an exaggerated sunburn reaction,
which limits its usefulness in the tropics

Syptoms such as fever, chills, headaches, and muscle aches, should be considered as an indication of malaria.
Malaria symptoms can sometimes not occur for months or even years after exposure.

Diarrhoea is a very common ailment when travelling. Most cases of diarrhoea when travelling are mild and do not require either antibiotics or anti-diarrhoea medicines.
Adequate fluid intake is essential for any traveller suffering from diarrhoea, to prevent dehydration.
The most important aspect of preventing diarrhoea is treatment and care, as far as food and water intake is concerned.
Travelers are advised to carry with them an antibiotic as well as an anti-diarrhoea drug, to be taken as soon as significant diarrhoea starts.(Three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period)
If diarrhoea is combined with nausea, vomiting, cramps, fever or blood in the stool, an antibiotic should be administered.
Ciprofloxacin (Cipro)(PDF) 500 mg twice daily or
Levofloxacin (Levaquin) (PDF) 500 mg once daily for a total of three days.
Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy.
An alternative treatment could be a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily.
Rifaximin should not be used by those with fever or bloody stools and is not recommended for pregnant women or children under the age of 12.
Azithromycin should be avoided in those allergic to erythromycin or related antibiotics.
An antidiarrhoea medicine such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowelmovements completely.
Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under the age of 2.

If diarrhoea is, severe, bloody, or if fever occurs accommpanied by shivering and chills, or if abdominal pain becomes severe, or if diarrhoea lasts for more than 72 hours, medical attention should be sought.
Although antibiotics are effective, they should not be taken as a prophylactic.

Food and water precautions;
Don't drink tap water unless it has been boiled, filtered, or chemically disinfected.
Don't drink unbottled beverages or put ice in your drinks unless you know that the ice is safe to drink.
Don't eat fruit or vegetables unless they have been washed very thoroughly peeled or cooked.
Avoid cooked foods that are no longer hot. because cooked food that has been left at room temperature can be very dangerous.
Avoid unpasteurized milk and any products that might have been made from unpasteurized milk.When using powdered milk make sure the water you mix it with is safe.
Avoid food and beverages obtained from street vendors.
Do not eat raw or undercooked meat or fish.

Information on Aids and Hiv virus in Mpumalanga South Africa.

HIV / AIDS IN AFRICA

HIV (Human Immunodeficiency Virus)is a variant virus of HTLV-1 (Human T cell Leukemia-Lymphoma Virus 1) and is the causative agent of AIDS (Acquired Immune Deficiency Syndrome) in South Africa

© Article by L-J Havemann - 2005 - reprinted with permission from www.mozambiquehappenings.co.za

Reference from Wikipedia

HIV (Human Immunodeficiency Virus) is a variant virus of HTLV-1 (Human T cell Leukemia-Lymphoma Virus 1) and is the causative agent of AIDS (Acquired Immune Deficiency Syndrome). AIDS first surfaced in June 1981 as result of reports from the Los Angeles area, to the Centre of Disease Control, of a type of pneumonia caused by a fungus in homosexual males.

The virus causing this disease was isolated by a group of French and American scientists in 1983.

The virus makes contact with a host cell, enters it and goes through a process of replication which damages and eventually kills the host cell. The infection begins when the virus binds to a protein receptor called CD4 receptor on the surface of helper T cells. Helper T cells are the cells which combat infections and diseases entering our bodies by combining with B cells to amplify antibody production.

Through a very complicated process helper T cells are killed and as the process progresses there is a decline in immune functioning. It can thus be said that technically AIDS does not kill a person but allows other opportunistic infections to enter the system. One of the most serious diseases resulting from AIDS is tuberculosis.

The infection begins when the virus binds to a protein receptor called CD4 receptor on the surface of helper T cells. Helper T cells are the cells which combat infections and diseases entering our bodies by combining with B cells to amplify antibody production. Through a very complicated process helper T cells are killed and as the process progresses there is a decline in immune functioning.

When HIV kills CD4+ T cells so that there are fewer than 200 CD4+ T cells per microliter of blood, cellular immunity is lost, leading to the condition known as AIDS.
When this happens, Aids sufferers are no longer able to fight viruses effectively, and should go on anti-retroviral drugs (ARVs) to prolong their lives.

There can be extreme reactions to the antiretroviral treatment itself. Nevirapine, particularly, can trigger Steven Johnson Syndrome, which causes excruciatingly painful burn-like blisters all over the body, while cancer in HIV children runs at 20 times the normal rate. Because of this, babies with HIV have only a 50/50 chance of lasting more than a year.

The disease is spread via body fluids contaminated with the virus.

The most common forms of transmission are;

1. Sexual contact between males to males, males to females or female to male through vaginal or anal intercourse with infected people
2. Exchanges of infected blood. This can be from infected blood transfusions or infected hypodermic needles. Open wounds or mucous membrane exposure is a risk factor in health workers.
3. The virus can also be transmitted from infected mothers to their infants before or during birth, or through breast feeding.

Although mosquitoes can carry the AIDS virus there is as yet no evidence that the virus can multiply inside a mosquito, nor that they are capable of transmitting the disease.

Two species of HIV infect humans: HIV-1 and HIV-2.
HIV-1 is more virulent and more easily transmitted. and is the source of the majority of HIV infections throughout the world,
HIV-2 is not as easily transmitted and is largely confined to West Africa.

Both HIV-1 and HIV-2 are of primate origin.

HIV-1originated from the Central Common Chimpanzee found in southern Cameroon.
HIV-2 originated from the Sooty Mangabey a monkey occuring in Guinea Bissau, Gabon, and Cameroon.

It is believed by experts that HIV probably infected humans as a result of direct contact with primates, during hunting or butchering them to eat.

A more controversial theory known as the OPV AIDS hypothesis suggested that the AIDS epidemic was accidentaly started in the late 1950s in the Belgian Congo by researchers trying to find a vaccine for polio. According to scientists the available evidence does not support this theory.

At this present time there are no safe drugs or vaccines to prevent the spread of AIDS. The only means of prevention is to stop the transmission of the virus. Medical science at the moment is mounting what must be the greatest concentrated effort ever, to find a cure for a single- virus disease. The male latex condom, if used correctly without oil-based lubricants, is by far the most effective available technology to reduce the sexual transmission of HIV and other sexuallytransmitted infections.(80% effective)

Manufacturers recommend that oil-based lubricants such as petroleum jelly, or butter, and margerine should not be used with latex condoms as they weaken the latex, and makes condoms porous.Manufacturers recommend using water-based lubricants.
Latex degrades over time, making the condoms porous. 

Africa is the hardest hit by this disease and poverty and ignorance are major factors contributing to the spread of the virus. Poverty and unemployment leads to people with nothing to do and so promiscuity increases.

This promotes a drift to urban centres looking for employment and as the individual's circumstances get more desperate so prostitution becomes more widespread. Cultural beliefs and customs and a lack of understanding of the dangers of unprotected sex through ignorance leads to the disease being spread more rapidly. The fact that the disease can lie dormant with no outward symptoms showing, belies the urgency of a radical change of attitude towards multiple sex partners and unprotected sex.

Although governments are embarking on campaigns to educate their people, it is very late in the day and more people than is fully realised are already HIV positive and sexually active and therefore still spreading the virus.

The stigma and secrecy surrounding the virus contributes to the rising HIV/AIDS prevalence rate in Africa.

The majority of children living with HIV have been infected by their mothers during pregnancy, childbirth or breastfeeding. Most of them have not had to face the psychological trauma of living with the virus because they died within the first two years of life.

Given the fact that there is no vaccine or cure for HIV or AIDS at present, the only methods of prevention are based on avoiding exposure to the virus.

Africa is the hardest hit by this disease and poverty and ignorance are major factors contributing to the spread of the virus.

The fact that the disease can lie dormant with no outward symptoms showing, belies the urgency of a radical change of attitude towards multiple sex partners and unprotected sex.

                                                                         
Children born of HIV mothers have a very high likelihood of contracting full-blown AIDS by the time they are five years old

OTHER RISKS

Diarrhoeal diseases, giardiasis, dysentery and typhoid fever are all common. Bilharzia (schistosomiasis) is present.
Avoid swimming and paddling in fresh water; swimming pools which are well chlorinated and maintained are safe.
Hepatitis A, B and E are present. Meningococcal meningitis may occur. Human trypanosomiasis (sleeping sickness) has been
reported. Plague has been reported in remote areas. Visitors should also be wary of the dangers of tetanus.

Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical
advice without delay.
SUNBURN:- Take plenty of sunblock of a high factor and stay out of the direct sun in the middle of the day.

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