Vaccination and Travel Information for Botswana

BOTSWANA

 Information current as at: February 2009 by The D2 Medical centre No 1 Fitzwilliam Street Dublin 2 Ph 6314500. The experts in travel vaccines Dublin 2.


Climate: Mainly temperate climate. Summer is between October and April and is very hot combined with the rainy season. Dry and cooler weather exists between May and September with an average temperature of 25ºC The rainy summer months (December through March) are best avoided for those interested in enjoying the best game viewing conditions. Botswana's climate can get rather cool, particularly during the dry winter months of June-August when night occasionally brings frost.
Capital City: Gaborone
Altitude: 1000 metres above sea level
Main Cities: Francistown, Lobatse, Selebi-Phikwe
Population: 1,464,167
Land Area (sq km): 581,730
Currency: 1 pula = 100 thebe
Languages: English, Setswana, other indigenous languages
Religions: Indigenous beliefs, Christian
Economy: Services, mining, Agriculture



The D2 Medical advises all travellers to be 'up-to-date' for:

CHOLERA Immunisation is neither required nor recommended.
DIPHTHERIA We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.
HEPATITIS 'A' This is the most vaccine preventable disease for travellers. Strongly recommended but not compulsory for all travellers to this area.
HEPATITIS 'B' Immunisation is strongly recommended for travellers who will be in the area for 1 month or more.
Transmission of Hepatitis B is through sex or contact with contaminated blood, needles and syringes.
MENINGO-COCCAL MENINGITIS Immunisation is neither required nor routinely recommended for travellers to the region.
POLIO Adults who are travelling to areas where poliomyelitis cases are occurring, or where the contracting the disease is possible, and who have received a primary series with either IPV or OPV should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.
RABIES Immunisation is recommended for travellers who will be in rural or remote areas for 1 month or more at a time.
TUBERCULOSIS (TB) Immunisation is not compulsory, and is not recommended for adults.
Children should be immunised at any age.
A skin test is available if immune status is in doubt.
TETANUS We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.
TYPHOID FEVER Immunisation is recommended.

YELLOW FEVER No vaccination requirements for yellow fever for any international traveller.

* World Health Organization:
The following countries and areas are regarded as Yellow Fever infected areas:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan (south of 15°N), Togo, Uganda, United Republic of Tanzania, Zambia.
America: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, Trinidad and Tobago, Venezuela.




Malarial Prevention is highly recommended. Malaria is predominately in the malignant (P. falciparum ) form. Moderate seasonal risk in northern areas and sporadic risk in southeastern border areas. Increased transmission occurs during and just after the rainy season, October to mid-April. Malaria is moderately endemic in northern areas, including the Boteti, Chobe, Ngamiland, Okavango, and Tutume regions. Limited transmission occurs along the south east border with South Africa, extending along the Molopo River bordering South Africa. Gaborone is essentially risk free, except in years with very heavy rainfall. Chloroquine-resistant P. falciparum reported.


Please read the side-effect profile of each regime before use. For details on antimalarials
1 = most recommended for the area, 4 = least recommended

1 = most recommended for the area, 4 = least recommended

 

TABLET NAME

OTHER NAME

STRENGTH

No. TO TAKE

FREQUENCY

1

Atovaquone / Proguanil

Malarone

250/ 100 mgs

1

Daily

1

Doxycycline

Doxy

100 mgs

1

Daily

1

Mefloquine

Lariam

250 mgs

1

Weekly

4

Proguanil
And
Chloroquine

Paludrine

Plaquenil
Q200, Q300

100 mgs

200 mgs
200 / 300 mgs

2

2
2-3 (600 mgs)

Daily

Weekly
Weekly

 

Warnings:

  • All travellers are advised to ask their health professional about the side-effects of the various medications, as problems may occur with balance/fine skills, heart disease, blood pressure pills, epilepsy, mental illness and pregnancy.
  • Not all medications are suitable for everybody, neither are any of the recommended medications 100%effective. Other mosquito preventative measures are recommended in association with any recommended medication (see below).

 

Self Treatment Regimes:

  • Travellers who develop fever should seek immediate medical help. If Malaria is confirmed then self-treatment regimes are available. Travellers may wish to discuss these with their health professional BEFORE they travel. They are best used in association with a firm diagnosis of malaria (which may be done either by a laboratory of with the aid of a ‘rapid diagnostic kit’).

 

General Advice on Mosquito Prevention.
Malaria is transmitted by mosquito bite, so recommend all travellers to the country to:

  • cover exposed skin after dusk when they are at most risk for getting bitten
  • use insect repellent with DEET in it.
  • return before dusk from country areas where malarial mosquitoes are the most active
  • sleep in screened room or use a bed net, remembering to tuck in the edges & spray inside.
  • sleep in air conditioned rooms or rooms with fans. Vapour pads and smoke coils also help. Insect buzzers are useless.




GENERAL
Medical facilities in Gaborone and Francistown are adequate, but available facilities in other areas are limited. For advanced care travellers are advised to travel to south africa. most prescription drugs are available. Medical facilities are basic in urban areas and poor to non-existent in rural areas. Some medicines are in short supply or locally unobtainable. For any major medical problems, including dental work, travellers should consider obtaining medical treatment in South Africa where more advanced medical care is available. Botswana is an exciting place to visit for game viewing, however, given the unpredictability of wild animals accidents do happen and hospitalisation is not uncommon. It is essential that all visitors to Botswana carry good travel insurance. The health care in Botswana is good but it is not cheap. Insurance should include air evacuations home.

HEALTH, ACCIDENTS AND INSURANCE
Accidents and injuries are the leading cause of death among travellers under the age of 55. Most are caused by motor vehicle and motorcycle crashes; and to a lesser degree, drowning, aircraft crashes, murders, and burns.

Heart attacks cause most fatalities in older travellers, but infections cause only 1% of fatalities in overseas travellers. Generally, infections are the most common cause of travel-related illness.

Travellers are advised to obtain, before departure, travel health insurance with specific overseas coverage. The policy should include a medical evacuation benefit. Check for any exclusions that are part of the policy, and keep in mind that many insurance policies have terrorism exclusion clauses. The D2 Medical recommends that the policy also provide 24-hour access to an assistance centre that can help arrange and monitor delivery of medical care, and determine if air ambulance services are required.

                                                                                                                             DR JOHN J RYAN MEDICAL DIRECTOR

 

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