Health Recommendations and Requirements for Africa Travellers

As travellers to Africa it’s vital you know what is required of you for entry into the countries you are visiting, as well as to be properly prepared for the conditions and threats that await you, such as malaria. This blog contains important information on the health requirements for travel to various destinations in Africa and focuses on malaria, yellow fever, typhoid and cholera.

Disclaimer: Before you travel please confirm with the World Health Organisation (WHO) or your local travel clinic what you find below. The WHO recurringly change their regulations and we urge you to confirm your requirements at the time of your travels.  

Malaria

Malaria is a mosquito-borne disease that is transmitted to people through the bite of infected female Anopheles mosquitoes. Malaria is preventable and curable, and increased efforts are dramatically reducing the malaria burden in many places. Between 2010 and 2016, the rate of new malaria cases fell by 18% globally. With that said, Africa carries a disproportionately high share of the global malaria burden and the necessary precautions should be taken when visiting the malaria areas in Africa. The map below shows the areas in Africa affected by malaria. In regards to the places our travellers visit, it’s most of Africa apart from the southern and western reaches of South Africa. If you are concerned about malaria, there are numerous safari options that are not in malaria areas such as the Garden Route Safaris and Madikwe Game Reserve.

The crux of the malaria matter is this: If you come prepared, you should easily avoid infection.

We recommend you speak to your doctor about malaria prevention before travelling to a malaria area, as the following information is not intended to replace that issued by your doctor.

Rule One: Avoid getting bitten

Rule number one of malaria prevention is that if you don’t get bitten, you won’t get malaria. Unfortunately, the female Anopheles mosquito that transmits malaria is a silent little mozzie and doesn’t buzz to warn you of its presence. Mosquitoes can bite at any time of day but are usually most active at dawn and dusk. Use the repellent sprays and wear long-sleeved shirts and long trousers in the mornings and evenings. The mosquitoes can bite through thin clothing so it’s important to spray insect repellant on covered skin as well as non-covered skin.

Most of the lodges have screened windows and doors, mosquito nets, air conditioning, fans, and plug-in deterrents. These all help to prevent you getting bitten, but should not be the used in isolation.

Rule Two: Take anti-malaria tablets if you are in a malaria area

It should be noted that no malaria prophylactic is 100% effective, as the malaria parasites become resistant to the various drugs. It’s vital that you speak to your doctor or travel clinic to advise you on the best prophylactic for you. Travellers should remember to take the tablets regularly and continue to take the prescribed dosage of tablets even after they have left the malaria area.

Different Malaria Prophylactics

Chloroquine, Proguanil and Maloprim: Malaria in certain parts of Africa (north of South Africa) has become Chloroquine resistant and therefore these drugs are decreasing in their popularity and fewer people are taking them.

Mefloquine (Larium): For many years Larium has taken a bit of beating. It is a very effective malaria prophylactic but it needs to be carefully dispensed as patients with a history of psychiatric disturbances can get unpleasant side effects.

Malarone: With virtually no side effects and a simple daily dose, this prophylactic is becoming an increasingly popular choice for travellers. In addition, Malarone has now been launched in the UK in a children’s formulation and is the first ever malaria tablet designed just for kids. It is also licensed in the USA, Denmark and is becoming increasingly available in Europe. The children’s version is a chewable once daily dosage that only needs to be started one day before travel commences.

This is the Prophylactic that we recommend but we urge you check your personal suitability with your doctor prior to travel.

Doxycycline: This is an antibiotic and for many people, it provides a perfectly good alternative to taking the traditional anti-malaria tablets. However, Doxycycline can make you particularly sensitive to the sun, and the effects of antibiotics on contraception tablets are well documented.

Garlic, Vitamin B, Chili: These are all old wives tails and should definitely not be used as prevention against malaria!

Rule 3: Look out for symptoms and complete your course of prophylactics

If on your return or during the remainder of your trip, you experience any flu like symptoms (nausea and vomiting, chills, fever, sweating, headache or muscle pain) you should have a malaria test just to be safe. Malaria responds well to early treatment. Remember to complete your prophylactic course — even after leaving a malaria area.

Yellow Fever

Yellow fever is a viral infection transmitted by mosquitoes. The yellow fever vaccination and certificate is a very complicated matter as the rules are different depending on where you’ve been in the past six months, where you’re coming from, and where you’re going. We’ll lay out the requirements as simply as possible but if you have any doubts please confirm your requirements with your travel consultant.

Rule 1

If you’re coming from the UK, Europe and US you don’t need a yellow fever certificate, unless you have been to a yellow fever area in the past 6 months or are going to Rwanda.

Countries with risk of yellow fever transmission, according to the World Health Organisation, are:

AFRICA – Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Republic of the Congo, Democratic Republic of the Congo, Côte d’Ivoire, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Sudan, Sudan, Togo, Uganda.

AMERICAS – Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Peru, Suriname, Trinidad and Tobago, Venezuela.

To see what is considered a yellow fever area, visit this World Health Organisation page https://www.who.int/ith/ITH_Annex_I.pdf

Rule 2

If you are going to Rwanda, you need a yellow fever certificate.

Rule 3

If, on your travels, you will be passing through Kenya, Rwanda, Uganda or other countries at risk of yellow fever (see above) before travelling to Botswana, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Reunion, Seychelles, South Africa, Swaziland, Uganda, Tanzania, Zambia or Zimbabwe, you need a yellow fever certificate. For more information, visit this World Health Organisation page –https://www.who.int/ith/ITH_country_list.pdf

If you are travelling to only Kenya or Uganda and not connecting with other countries on your travels and then returning home to a country not at risk of yellow fever such as US, UK, Canada, France, Germany, Ireland, Switzerland, Netherlands, Italy, or New Zealand you do not need a certificate.

HOWEVER

People travelling to Australia over one year of age require a yellow fever certificate if coming from countries with a risk of yellow fever transmission and for travellers having transited more than 12 hours through the airport of a country with risk of yellow fever transmission.

Rule 4

If you are younger than 9 months you do not need a yellow fever certificate.

Rule 5

If you have spent, in the past six months, or will spend more than 12 hours in transit at an airport in a country with a risk of yellow fever transmission you need a yellow fever certificate. To see what is considered a yellow fever area refer to Rule no. 1 or visit this page https://www.who.int/ith/ITH_Annex_I.pdf.

Example 1
If you live in the US, have not travelled in the past six months to a yellow fever area, and are travelling to Kenya and then Tanzania, you will need a yellow fever certificate.

Example 2
If you live in the UK, have not travelled in the past six months to a yellow fever area, and are visiting Uganda, Rwanda and Kenya, you will need a yellow fever certificate.

Example 3
If you live in Australia, have not travelled in the past six months to a yellow fever area, and are just visiting Southern Africa, you do not need a yellow fever certificate.

Cholera

No country requires a certificate of vaccination against cholera as a condition for entry. It is a disease of poverty, closely linked to poor sanitation and lack of clean drinking water. Occasionally, there are reported cases of cholera in Africa but those are restricted to small poverty-stricken areas that travellers do not visit, so the threat is insignificant.

 Typhoid

Typhoid fever is usually caused through the ingestion of contaminated food or water. It occurs predominantly in association with poor sanitation and lack of clean drinking water, something that our guests will never be subjected to.

When in rural areas remember to follow these general rules:

• Drink bottled water (preferably carbonated)
• Avoid eating at street food stands, and only eat food that is still piping hot

This information was correct at time of publication but we urge you to speak to your health professional for up-to-date and expert advice.