People’s Easter pilgrimages to warmer places might mean that they will come home with malaria, health authorities have warned.

Although homesteads in high-risk areas in Limpopo and Mpumalanga have been sprayed with pesticides recently, Erick Mabunda, Deputy Director of Limpopo’s Malaria Institute, warned that malaria cases often peaked after the Easter break.

“For the past two seasons, we had peaks after Easter holidays. In 2017, we had outbreaks two weeks after these holidays when people came back from their respective countries, so even this year we have to be careful,” said Mabunda.

Masilo Motloutsi, from Khujwana Village outside Tzaneen, and two friends contacted the disease when they were working as contract labourers at Musina on the border with Zimbabwe in August last year. One of his friends succumbed to the disease.

“People should always go and test whenever they feel sick because you will never know what hit you until it’s late, as some symptoms are normal to us like headache and feeling weak,” said 23-year-old Motloutsi.

“I consider myself very fortunate and lucky as I was not aware what is happening to me. I didn’t know any symptoms of malaria. I first had a headache and my body got weak and I notified my mother and she took me to the clinic,” he said.

Almost died

Meanwhile, Mercy Nemavhola from Tshipako village near Thohoyandou, contracted malaria three years ago and almost died and now lives in fear of getting it again.

“I fought off death. By the time they found out that I had malaria, I was very sick and I couldn’t even eat on my own and it was already at an advanced stage. I thought I was going to die,” said Nemavhola.

She spent three weeks at Vhufuli hospital in 2016, while three of her siblings spent two weeks at the same hospital last year with malaria.

The entire Vhembe district is a malaria risk district, according to the National Institute for Communicable Diseases (NICD), and with climate change and increasing temperatures, more and more areas throughout are becoming at risk of malaria.

Mathematical modelling by the World Health Organisation (WHO) shows that small increases in temperature are likely to have a significant effect on malaria transmission potential.

“Globally, temperature increases of 2 to 3ºC would increase the number of people who, in climatic terms, are at risk of malaria by around 3 to 5%, or several hundred million people,” according to the WHO, which warns that the seasonal duration of malaria will increase in many currently endemic areas.

Meanwhile, getting malaria treatment in time is a challenge for many people as it usually takes time for them to recognise the early symptoms, which can be mistaken for flu.

When Rendani Sirwali from Khubvi village, outside Thohoyandou was rushed to Tshilidzini Hospital few months ago, she was told that her malaria was already at an advanced staged and, had she arrived a few hours later, she might have died.

“I had several symptoms of malaria but I chose to ignore them and thought that it was just a flu,” said 44-year-old Sirwali.

“I never thought that it could be malaria as I had never seen anyone with malaria before. I have now taken it upon me to educate other people about the importance of visiting their nearest health facilities early when they feel that they are having any symptoms of malaria.”

Cyclone Idai danger

The recent Cyclone Idai in Mozambique has also increased the risk of malaria. Mandla Zwane, the Mpumalanga Health Department’s Director of Communicable Diseases, said that the province had dealt with 4806 cases up to the end of March with only 28 fatalities.

“Due to the high movement of people towards or during Easter holidays, there is a high risk of cross boarder transmission of various infectious diseases like malaria,” said Zwane.

“They might come with mosquitoes from any countries that endemic to malaria. As the province in Mpumalanga we are surrounded by Mozambique and Swaziland on other side there is Limpopo province that is next to Zimbabwe. Any transmission is possible to affect our province.”

This Wednesday (25 April) is World Malaria Day. Malaria cases have started to increase again in the past two years after 10 years of no increase. The plasmodium parasite that causes malaria is becoming more resistant to medicine while the mosquitos that carry it are becoming more resistant to pesticides.

“World Malaria Day offers people all over the world the opportunity to step up the fight against malaria at a time when global malaria cases are on the rise and funding has flatlined,” says Dr Winnie Mpanju-Shumbusho, Board Chair, RBM Partnership to End Malaria.

“In 2017, for the first time in ten years, the number of malaria cases increased again, affecting 219 million people,” according to Professor Agnès Buzyn, French Minister for Solidarity and Health

“The African continent accounts for over 90% of this burden and seven West and Central African countries are among the most affected. We must give ourselves the means of fighting this preventable and treatable disease, that kills one child every two minutes. On the 25th April, France will reassert its full commitment to the fight against malaria, through multilateral financing, as well as through our government agencies, civil society and our research institutes.”

Meanwhile, Zwane has practical advice: “Watch out for flu-like symptoms such as fever, headache, shivering or sweating, body pains, loss of appetite, nausea and vomiting. If you have visited areas known to have malaria and have one symptom, you should visit your health facility or doctor urgently.”