Health Regulations in Kenya

Malaria Health Regulations in Kenya

Travel Hints on Malaria

Being ill far from home can dull the pleasure of any travel. Visitors to Kenya and residents alike will find this health regulations (malaria) information useful in reducing their risks. Malaria is an indiscriminate disease. Almost everyone can get infected with malaria. Worst still, overseas travelers have a 50% higher chance of getting infected with malaria. And the symptoms of malaria may not be felt until travelers have returned home, “It takes 5.5 days to 30 days for the parasite to mature in the human liver before been released into the blood and consequently infecting the blood cells”, notes Sara Mazursky of Johns Hopkins University. TV presenter Kate Humble who recounted her ordeal with Malaria not once, but twice (in Ghana and Zanzibar), says “it is the classic traveler’s error of thinking that they are only going to a malaria area for a few days and it is simply not worth taking the pills for weeks on end.” Yes, travel agent ought to be more responsible about warning travelers of inoculation issues associated with specific destination but there are precautions visitors to Kenya can initiate.

Brief Overview of Malaria

Malaria is a deadly disease which causes up to 1 million (2 every minute) deaths globally. 350 million new cases are reported annually – WHO’s estimates. 90% of all cases occur in children below five years of age and is the leading cause for child mortality in young children and pregnant mothers around Africa. Humans become infected with the malaria parasites when they are introduced into the human bloodstream by the bite of an infected female Anopheles mosquito while it takes a “blood meal.” After maturing and multiplying in the red blood cell, the cell bursts and the parasites invade other red blood cells. This part of the life-cycle is known as “asexual reproduction.” During the life-cycle in the human host, some of the parasites that infect red blood cells will mature into sexual forms known as gametocytes. The mosquito, during a “blood meal,” must ingest both the female and male gamteotcyes for the parasite’s life-cycle to continue. Male and female gametocytes fuse in the mosquito’s gut to form a zygote. This zygote divides producing sporozoites. This phase of the life-cycle is termed “sexual reproduction.” Sporozoites travel to the mosquito’s salivary glands and must be passed to a human on a subsequent blood meal to complete the cycle.

Symptoms of uncomplicated malaria caused by any of the four species include:

Fever with alternating chills and sweats
Headache and body aches
Vomiting in young children

Symptoms of complicated malaria, almost exclusively associated with Plasmodium Falciparum include:

Severe anemia
Cerebral malaria as coma or recurrent seizures
Respiratory distress resulting from pulmonary edema
Kidney or liver failure, and other complications
Rupture of the spleen

Severe malaria can develop within 24 to 48 hours of onset of illness and even with treatment, up to 20% to 40% of patients who develop severe malaria will die. Some patients who do survive cerebral malaria suffer from long-term sequelae, including development delays, learning disabilities and brain damage.

Ways to Mitigate Malaria

Ensure your vaccines and medications are up to date before your visit to Kenya. The Center for Disease Control (CDC) recommends the following chemoprophylaxis for malaria before your travel: Atavaquone-proguanil, doxycyline, or mefloquine. The combination and administration of these drugs differ from country to country (consult a tropical diseases specialist or travel clinic for advice). So far, there is no licensed vaccine for malaria. However, many organizations, including USAID, have active programs to develop one. GSK’s vaccine is currently undergoing a multicentre phase 3 field trial in 11 different sites in seven countries in Africa. Other vaccines to consider when visiting Kenya are: Hepatitis A, Hepatitis B, Typhoid, Polio.

On the off-chance you have visited Kenya without taking prophylaxis: Inquire which doctors to see from you travel insurance or international medical insurance provider. Most international medical providers have satellite clinics or appointed doctors in all major towns in Kenya. If you are unable to reach your insurance provider, you can visit any Government of Kenya Dispensary, Health Centre, Sub-County, County Level 5 or National Hospital where antimalarial drugs are offered free-of-charge. Alternatively you can visit any for-profit medical facilities and request for appropriate malaria drugs, at a minimal fee. As a last resort, you can visit a dispensing chemist and request for anti-malaria drugs. The most popular anti-malaria drug in Kenya is Artemether-Lumefantrine (locally referred to as just AL).

Always sleep under an insecticide – treated net (ITN) especially at night when malaria is almost always transmitted. ITNs undergone periodic treatment with pyrethroid insecticides that have a very limited toxicity to human. The Public Health Impact of Individual Coverage has documented that use of a treated net is one of the best forms of personal protection in malaria-endemic areas. The effectiveness of untreated bed nets is limited because mosquito can be trapped inside the net, or find their way inside it. Extensive studies show that ITNs reduce episodes of malaria by up to 50%.

When away from enclosed areas, especially at night, always ensure that you have covered up well: long sleeves tops, long skirts or trousers and scarfs. This will drastically reduce the mosquito bites. Insect repellent can also reinforce your efforts to ward off the deadly insect. Likewise, spray your residential areas with local insecticide at night, especially just after dusk when mosquitoes begin their rampage, or install the electric version.

More Useful Health Regulation Hints for Kenya

Arrange for travel insurance and international medical cover
Have a list of doctors and clinics you can visit while in Kenya
Visit your doctor before and after travelling to Kenya
Check for any medical travel alerts and risks
Pack a first aid, especially if you are travelling with the children
Drink only bottled or boiled water
Eat only freshly cooked meals, while hot. Avoid food vendors
Avoid other insect bites by dressing appropriately and wearing closed shoes while outdoor