Vaccination and Travel Information for Malawi

MALAWI

 Information current as at:  February 2009 by The D2 Medical Centre No1 Fitzwilliam Street Upper Dublin 2 ph 6314500. The experts in travel vaccines Dublin 2.


Climate: Varies from cool in the highlands to warm around Lake Malawi. Winter (May through to July) is dry and nights can be chilly, particularly in the highlands. The rainy season runs from November to March. Around Lake Malawi, in winter, the climate is particularly dry with pleasant cooling breezes. In the south the climate is tropical with temperatures all year round fo 28 to 37 Celsius. The average annual rainfall is 740mm / 30 inches. There are more moderate temperatures in the central region and heavier rainfall 1500 to 2000 mm / 60 to 80 inches.
Capital City: Lilongwe
Altitude: 1030 metres above sea level
Main Cities: Blantyre
Population: 11,008,000
Land Area (sq km): 118,484
Currency: 1 Malawi Kwacha = 100 tambala
Languages: English, Chichewa, Lomwe
Religions: Protestant, Animist, Christian, Sunni Muslim
Economy: Tobacco, sugar, tea, textiles



 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 travel 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 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 A yellow fever vaccination certificate is required from travellers coming from infected areas ( see * below ).


* 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, predominately in the malignant (P. falciparum) form, is present all year round in the whole country. Malaria risk is highest along the shores of Lake Malawi, where the risk is highest at the end of the rainy season, November until April. Falciparum malaria accounts for approximately 90% of the cases. The rest of the cases of malaria are due to the P. ovale and P. malariae species, rarely P. vivax. P. falciparum resistant to chloroquine and sulfadoxine–pyrimethamine is reported.

There are five common medications for malaria prevention available in Ireland. They are: chloroquine, doxycycline, malarone, mefloquine, paludrine. To determine the appropriate antimalarial, it is advised that the traveller discuss this with a Worldwise Travellers Health Specialist or other Travel Health Professional. None of the medicines are 100% effective against the disease at all times, and each has its own side effects. These need to be discussed with the intending traveller.

 

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.

Malaria map of Malawi




GENERAL
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.

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.

Yellow Fever Map
 


                                                                                                                                    DR JOHN J RYAN MEDICAL DIRECTOR

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