Vaccination and Travel Information for Mozambique

MOZAMBIQUE

 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: The dry season runs from April to September, when temperatures reach 27°C. The rainy season lasts most of the rest of the year, when temperatures reach 31°C.
Capital City: Maputo
Altitude: 50 metres above sea level
Main Cities: Beira, Nacala, Nampula
Population: 15,823,000
Land Area (sq km): 801,590
Currency: 1 metical = 100 centavos
Languages: Portuguese, Bantu languages
Religions: Roman Catholic, Muslim, Animist
Economy: Agriculture, trade



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

CHOLERA Immunisation is neither required or routinely 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 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.


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 staying in rural areas for 1 month or more.


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.
Tuberculosis is endemic in this country.

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 over 1 years of age 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.




High risk is present throughout this country, including urban areas. There is increased malaria risk along the coast and in the lower Zambezi Valley. Outbreaks are reported in Xai-Xai and Maputo. Malarial Prevention is highly recommended. Malaria, predominately in the malignant (P. falciparum) form, is present all year round anmd accounts for 95% of cases of the disease.

There are five common medications for malaria prevention available in Ireland. None of the medicines is 100% effective against the disease at all times, and each has its own side effects. Listed below in order of preference are our recommendations for this country.

Please read the side-effect profile of each regime before use.
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.

Malaria map of Mozambique




GENERAL
Medical facilities are rudimentary, and many medicines are unavailable. Doctors and hospitals often expect immediate cash payment for health services. Maputo's Sommerschield Clinic can provide general and basic emergency services and requires cash payment in advance. 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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