MALARIA

1. Members of the Provincial or District Malaria Control teams visit clinics in endemic areas every month during spraying activities throughout the year.

2. During peak transmission times October – May visits are more frequent.

1.1 Malaria Control Policy in South Africa – Latest version.
1.2 Latest Guidelines for the Prophylaxis of Malaria.
1.3 Latest Guidelines for the Treatment of Malaria.
1.4 Pamphlets on Malaria control Programme.
1.5 Pamphlets on Malaria diagnosis and treatment and prevention in local languages.
1.6 Posters in local languages.

2.1 Laboratory equipment – rapid diagnostic tests on microscopic slides of blood smears.

3.1 List of drugs in accordance with the Essential Drugs List.

4.1 Staff receive training and periodic continuing education on malaria control and malaria clinical management.
4.2 Staff know if the clinic is in an endemic area of Northern Province, Mpumalanga, N-E KwaZulu-Natal, or in an occasional focal limited epidemic area of N-W Province and N Cape.
4.3 Staff know the highest transmission period (e.g. Oct-May) and its relation to rainfall and abnormal seasonal patterns.
4.4 Staff keep a high level of suspicion of fevers, persons coming from other endemic countries (e.g. Mozambique) and are thus capable of making early diagnosis to offer rapid treatment.
4.5 Staff regard all South Africans as non-immune and prone to severe complications.
4.6 Staff provide information on personal preventive measures and prophylactic treatment to travellers and tourists in high risk areas.
4.7 Staff treat suspected uncomplicated malaria as per malaria protocol.
4.8 Staff refer urgently to hospital all suspected severe cases.
4.9 Staff confirm diagnosis with blood test either by blood smear for microscopy to laboratory or rapid diagnostic tests.
4.10 Staff repeat blood test if negative and symptoms persist.

The following are referred:

5.1 All children after initial treatment with tepid sponging and rehydration.
5.2 Patients not responding to treatment within 4 days.
5.3 Patients with symptoms of severe and complicated malaria (recording blood glucose, weight and what treatment if any already given on the referral form).
5.4 Pregnant patients.
5.5 Patients with skin reactions to treatment.

6.1 All patients receive in high risk areas health education on preventative measures: use of impregnated bed nets/curtains, use of repellents on skin, aerosols, coils, vaporisers with insecticides, use of prophylactic drugs and about continuing precautions all year.
6.2 Clinic staff discuss the purpose of vector control measures and house spraying and larval control in endemic areas, reasons for active detection of cases and treatment in homes by malaria control field teams.

7.1 Patients records are kept up to date.
7.2 All confirmed cases of malaria are notified to the malaria control programme.

8.1 Clinic staff co-operate with the Malaria Control team and Environmental Health Officers by recording community responses to residual insecticide (e.g. replastering) and any social changes (e.g. influx of migrant workers).

9.1 Clinic staff collaborate with other departments like environmental health, water affairs and education.