Cause of Malaria

Malaria is caused by a microscopic sized parasite called Plasmodium.

This process involves a very complex mosquito - human being life cycle:
A female Anopheles mosquito itself infested with a Plasmodium parasite bites a human being. This parasite which has multiplied in the mosquito salivary glands is then injected into that person's bloodstream.

The Plasmodium parasite then moves to the human liver where it multiplies again. It is later released into the human blood stream which causes the symptoms of Malaria. The infected human being is subsequently bitten by another mosquito which in turn bites and transmits Malaria to another human being.

The commonest forms of Malaria are Plasmodium vivax which is rarely fatal and Plasmodium falciparum which can be fatal. The other forms, Plasmodium Ovale and Plasmodium Malariae are not so important.

Incidence:
Malaria is one of the 10 most prevalent and fatal diseases worldwide. Approximately 1.5 -2.7 million people die from Malaria each year with 300-500 million people infected at any given time.
About 90% of cases are in sub Sahara Africa with most fatalities in young children in remote rural areas.
About another 6-7% of Malaria cases are from India, Brazil, Sri Lanka, Vietnam, Colombia and the Solomon Islands.
Indonesia has a relatively low incidence of Malaria especially large cities and major tourist areas e.g. Jakarta and Bali. Risks are greater in remote areas.

Prevention of Malaria-
1. Be aware of the local incidence of Malaria:
Not always easy to get this information.
Overall risk in Indonesia is about 1:50,000 but varies greatly with location eg risk much higher in Irian Jaya than Bali.
Likelihood of contracting Malaria increases with time spent in the area.

2. Reduce exposure to Mosquitoes:
Obsessive prevention of mosquito bites reduces the risk of contracting Malaria about ten -fold.
Use mosquito nets preferably treated with permethrin unless in reasonable standard accommodation in a low risk area.
Spray an aerosol insecticide in your room before retiring.
Use mosquito coils or vapourising mats containing pyrethoid.
Cover arms and legs from dusk to dawn – the time when the female Malaria mosquito bites.
Avoid dark areas or garden areas from dusk to dawn.
Use mosquito repellents preferably those containing DEET eg “RID”, “Tropical Strength AeroGard”, “Autan” (a local brand).
Wear light coloured clothing.
Scent attracts mosquitoes –avoid perfumes and after shaves.

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Common Illlnesses In Indonesia

Common Illlnesses In Indonesia
COMMON ILLNESSES

The most common adult and childhood illnesses are the same as those in your country eg. coughs, colds and flu and ear infections but there is a higher incidence of stomach upsets with associated vomiting and diarrhoea.

Gastrointestinal Infections:
• There is a wide range of these infections including eg Travelers’ diarrhoea, food poisoning,
• Hepatitis A, Typhoid Fever, parasites eg Giardia and Entamoeba.
• These infections are transmitted by the faecal-oral route from contaminated food or water. “If you can’t cook it, peel it or boil it, leave it”
• Avoid infection simply by careful food handling and food choice, eg avoid shellfish, raw fish and salads, do not drink tap water.

Diarrhoea:
Most expats will suffer at least one bout of this very common problem. Treatment:
- Fluid replacement eg water or Gastrolyte.
- Do not use lemonade etc.
- Avoid dairy foods for a few days.
- Take Imodium to control diarrhoea.
• If you have a high fever, if you feel very ill, if you pass blood or if the Diarrhoea persists for more than 3 days or if you are worried then see a doctor.

Skin conditions:
• Fungal infections such as Tinea, Thrush and Ringworm are common.
• Wear cool clothing, dry feet & skin creases thoroughly after showering.
• Topical fungicidal creams eg Canesten are available over the counter.

Ear Infections:
• Swimmers ear or Tropical Ear is a very painful, common condition. It does not indicate a dirty pool. • Aqua Ear should be used after swimming to dry the ears particularly if you or your children frequently use the pool. • Ear plugs may help but are rarely completely effective.

Flu:
• Coughs and colds and flu are more frequent in Indonesia especially in
new arrivals.
• Treat with bed rest, extra fluids and Paracetamol or Proprietary Cold Flu
preparations. Antibiotics are not effective. • If you feel particularly unwell or in doubt about the problem see a doctor

Sexually Transmitted Diseases:
• These are very common especially Gonorrhoea and Chlamydia. Less common are Genital Herpes, Genital Warts and Syphilis. IV drug use is extremely dangerous.
• Hepatitis B is very common in Indonesia and can be transmitted sexually.
• HIV/ AIDS is uncommon but the incidence is increasing.
• Safe sex is essential. Avoid using local brand condoms.
Reputable brands of condoms are available from the clinic, hospital or pharmacies.

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Tropical Diseases Living In Jakarta

Malaria:
• Malaria is uncommon in all major cities, most of Java, Bali and generally in major tourist resorts. Malaria prophylaxis is not necessary in these areas.
• All other areas are presumed to be Malaria areas especially rural districts.
• Mosquito protection is essential to protect from Malaria and other mosquito borne infections in all parts of Indonesia.
• Risk of Malaria depends on length of stay, type of accommodation and destination.
• If you traveling outside Jakarta contact your Doctor to advice on Malaria prophylaxis.
• Any fever after traveling in Indonesia must be investigated to exclude Malaria.

Typhoid Fever:
• Typhoid is contracted from contaminated food and water.
• It is an uncommon infection in expats but common in the Indonesian population.
• Clinical diagnosis is difficult. Laboratory diagnosis takes 3-4 days so antibiotic treatment is usually started if Typhoid Fever is suspected.
• Vaccination is recommended but does not give complete protection.

Dengue Fever:
• Dengue is a viral illness spread by mosquitoes. Most cases occur during the wet season from about December to May.
• Symptoms are usually similar to the Flu. Often Dengue is mistaken for flu.
• Normally Dengue is a self limiting illness but rarely it does occur in a much more severe form known as Dengue Haemorrhagic Fever.
• Treatment of mild Dengue is rest, fluids and paracetamol with initial regular blood tests to check that the severe form of Dengue or complications are not developing.
• Prevention is simply to avoid mosquito bites and ensure there are no mosquito breeding sites eg free standing water around your accommodation.

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