By Ann Arnott

Undoubtedly, taking a trip through the wild expanses of Africa promises excitement and adventure. But let’s not forget, out in the wilderness, insects and animals may well find you to be a handy snack, so it’s best to take precautions to make sure your experience is unforgettable… in a good way!

In Africa, three of the leading causes of death are Malaria, Tuberculosis and HIV/AIDS. Here’s a closer look at these diseases, along with some other common health hazards that you should avoid.

HIV/AIDS
Whilst there’s currently no vaccine available for the prevention of HIV/AIDS, sexual transmission can be avoided through the use of condoms when engaging in sexual activities. Other risks involve contracting HIV via a blood transfusion with infected blood or if you’re given an injection with a previously used needle. Always insist on being given all the facts before consenting to treatment in a makeshift clinic in a rural area.

TUBERCULOSIS
When it comes to Tuberculosis, the Bacillus Calmette-Guérin (BCG) vaccine is effective in protecting infants and young children from severe forms of the disease, but it doesn’t protect adolescents and adults from contracting pulmonary tuberculosis. The main symptom is coughing up spit containing blood and the best treatment is a course of antibiotics taken regularly for 6 months.

MOSQUITO-BORNE DISEASES
Did you know that the mosquitoes that transmit diseases are all female? The males do not attack humans or animals as they prefer to feed on the nectar and sap of plants. The females, on the other hand, need the protein in blood to produce their eggs. However, not all female mosquitoes carry diseases. Only mosquitoes that have fed on infected hosts will transmit diseases to their next victims.

In sub-Saharan Africa, stretching all the way down to the northern and eastern parts of South Africa, the following diseases are known to be spread through the saliva of infected mosquitoes:
– Malaria: caused by a parasite transmitted through the saliva of an infected female Anopheles mosquito. Symptoms include chills, fever, sweating, headaches, aching muscles, fatigue and nausea. (Prevalent in 38 African countries)
– Dengue Fever: A viral infection transmitted by the Aedes mosquito, causing high fever, severe headache, and joint pain. (Endemic in at least 34 African countries)
– Zika Virus: A viral infection transmitted by the Aedes mosquito. This virus can cause serious birth defects if a pregnant woman is infected. (Found mainly in Uganda, Tanzania, Nigeria and South Africa)
– Chikungunya: A viral infection transmitted by the Aedes mosquito, causing fever, joint pain, and rash. (Occurring in at least 11 African countries)
– West Nile Virus: A viral infection transmitted by the Culex mosquito, causing fever and headache. In some cases, it also leads to encephalitis or meningitis. (Found in North, West and Southern Africa)
– Yellow Fever: A viral infection transmitted by the Aedes mosquito, causing fever, headache, and in some cases, jaundice. (Found in at least 25 countries in Africa)
– Japanese Encephalitis: A viral infection transmitted by the Culex mosquito, causing encephalitis in some cases. (Mainly in Angola)
– Lymphatic filariasis (elephantiasis): This is a parasitic disease caused by thread-like worms that are transmitted via infected mosquitoes, including the Culex, Anopheles, Aedes and Mansonia mosquitoes. Symptoms include redness, swelling and pain in the affected area. The worms can grow up to 10cm (female) and 4cm (male) in length. They form nests in the human lymphatic system and they produce millions of small larvae that circulate in the blood. If left untreated, they cause excessive enlargement of the legs, breasts and genitals of the victims. (Endemic in 35 African countries)

PREVENTION
Protect yourself from mosquito bites:
– Wear long sleeves, pants and socks.
– Use insect repellent containing DEET or picaridin.
– Stay indoors at dawn, dusk and at night.
– Sleep under a mosquito net.
Take Anti-Malaria tablets:
While anti-malaria tablets won’t help with the other mosquito-borne diseases, taking these tablets before, during and after your trip is highly recommended. Speak to your nearest travel clinic for advice on which tablets are best suited to your needs.
Be vaccinated against Yellow Fever:
For most countries where Yellow Fever is prevalent, a Yellow Fever vaccination is mandatory. However, if you prefer, go ahead and have the vaccination even if you’re not headed for a Yellow Fever zone. A single dose of the vaccine should protect you for life. You just need to keep your vaccination certificate handy to prove that you’ve had it.

TSETSE FLIES
Tsetse flies cause sleeping sickness in humans. They normally bite during the day and are attracted to very dark colours, which is why it’s recommended that you wear neutral-coloured clothes if you go on a safari or overland trip.
Symptoms include fever, skin lesions, rash and swollen lymph nodes on the back of the neck. You may experience daytime sleepiness, insomnia at night, confusion and various psychiatric disorders.
Treatment: It’s best to consult a medical professional to check which treatment is most suitable. Currently, a drug called Fexinidazole may be administered, depending on whether it’s considered the right solution for you.

TOP TIP
Apparently, tsetse flies hate the smell of Dettol, so spraying the vehicle you’re travelling in and your clothes with Dettol could be a good deterrent.

SANDFLIES
Leishmaniasis, a parasitic disease transmitted by sandflies, is endemic in many African countries, particularly in East Africa, North Africa, and certain areas of South Africa, with both cutaneous and visceral forms occurring. (Found in more than 16 African countries)
– Cutaneous Leishmaniasis: Causes skin sores or ulcers.
– Visceral Leishmaniasis: Also known as kala-azar, this disease affects internal organs and can be fatal if untreated. People who have Visceral Leishmaniasis usually have fever, suffer weight loss and have an enlarged spleen and liver. Some people also have swollen glands.
Causes: Sleeping outdoors increases the chance of sandfly bites in the affected areas.
Environmental changes, such as deforestation and denuding the land of vegetation as well as the building of dams and large-scale irrigation schemes may contribute to the spread of Leishmaniasis.
Treatment: In addition to topical creams and medicines, three treatments recommended for Cutaneous Leishmaniasis are:
– Cryotherapy: Using cold temperatures to freeze and destroy the parasite and lesion;
– Thermotherapy: Using heat to kill the parasite; and
– Laser Therapy: Using lasers to vaporize the lesion.
Visceral Leishmaniasis should be treated by a medical professional at a clinic or a doctor’s consulting room. Liposomal Amphotericin B may be administered intravenously over a period of 2 to 6 hours. The patient must be adequately hydrated before and during the procedure.

TETANUS
If you have never had a tetanus injection or it’s been longer than 10 years since you had a booster, it’s recommended that you have a tetanus injection before you set off on your adventure.
A tetanus infection, caused by a bacterium called Clostridium tetani, could be the result of an animal bite or a wound exposed to animal dung or dirt. Anyone who hasn’t had a tetanus booster prior to such an injury should go for a tetanus injection within 48 hours, to prevent complications. Keeping the wound clean and dry is also important.

BILHARZIA (SCHISTOSOMIASIS)
Bilharzia (Schistosomiasis) is contracted when you come into contact with contaminated water that contains freshwater snails. These snails act as hosts to larvae that develop into tiny worms. When these worms come into contact with people who are wading, paddling, washing or swimming, they burrow under their skin and enter their bloodstream. The worms then travel through the bloodstream to organs such as the liver or bowel, where they lay eggs. The eggs are then passed out of the body via the person’s stools or urine.

Symptoms of possible infection may start shortly after exposure to contaminated water, when the person develops a skin rash that becomes itchy. Other symptoms that may show up later include a vague feeling of being unwell, chills, fever, fatigue, muscle aches, a cough, abdominal pain and diarrhea. These may progress to signs of blood in the stools and urine, cystitis and anemia.  

However, there are some occasions when no symptoms show up so, when it doubt, have yourself tested when you return home.

PREVENTION
– Look out for signs that indicate that you’re entering a Bilharzia area.
– Avoid paddling or swimming in freshwater lakes, dams, rivers, reservoirs known to be contaminated.
– Avoid drinking the water from local water fountains and taps. Make sure you boil or filter water taken from streams.
– Avoid showering with water taken from an untreated freshwater source.
– Refrain from washing clothes, shoes etc in water that may be contaminated.

TREATMENT
The good news is that Bilharzia can be successfully treated with a short course of Praziquantel, which may be repeated after a few days, to ensure that all the larvae are eradicated.

CONCLUSION
This information might seem a lot to take in. But, basically, we’re only talking about a handful of micro-predators here: mosquitoes, sandflies, tsetse flies, bacteria and tiny worms. In most cases, these diseases are found elsewhere in the world, too, such as the Middle East, Asia and South America. However, when travelling through Africa, it’s preferable to be informed so you know what to look out for if you start to feel unwell.

References:
https://www.mediclinic.co.za
https://www.cdc.gov
https://www.aho.org
https://www.nicd.ac.za

Other useful links:
Travel Checklist – Paperwork
Travel Checklist – Overlanding Africa

Photo Credits:
Wolfgang Hasselmann, National Institute of Allergies and Infectious Diseases, and Phil Desforges