Malaria In Angola: Understanding The Risk And Reality

Angola is a country with a high risk of malaria. The disease is transmitted throughout the country, and 100% of the population is at risk. The central and coastal provinces are mesoendemic with stable transmission, while the four southern provinces bordering Namibia have highly seasonal transmission and are prone to epidemics. The risk of malaria is so high in Angola that the CDC recommends that travellers to the country take prescription medicine to prevent the disease.

Malaria prevention in Angola

Angola is a country with a high prevalence of malaria, with the entire population at risk of infection. The disease is primarily caused by the Plasmodium falciparum parasite and is spread by the female Anopheles mosquito. Travellers to Angola are advised to take prescription medicine to prevent malaria, with the type of medication depending on the traveller's specific situation. It is recommended to start taking the medication multiple days before the trip, as well as during and after.

To prevent bug bites from mosquitoes, ticks, and fleas, travellers can take several measures. These include wearing long-sleeved shirts, long pants, and hats to cover exposed skin. Using insect repellent containing 20% or more DEET is also effective against ticks and mosquitoes, while products containing picaridin, oil of lemon eucalyptus, or para-menthane-diol can protect against mosquitoes. Staying in air-conditioned or screened rooms and using bed nets are also recommended.

Additionally, it is important to practice safe food and water choices when in Angola. Contaminated water and food can lead to infections, so choosing safe food and drinks and treating water when hiking or camping is essential.

Malaria risk factors in Angola

Angola is a country with a high risk of malaria, with the entire population at risk of contracting the disease. The central and coastal provinces (Benguela, Bie, Cuanza Sul, Huambo, Luanda, Moxico, and Zaire) are mesoendemic with stable transmission. The four southern provinces bordering Namibia have highly seasonal transmission and are prone to epidemics.

Risk Factors

Environmental Factors

The risk of malaria is influenced by environmental factors such as distance to rivers, lagoons, and healthcare centres. The prevalence of malaria is also associated with rainfall, temperature, and proximity to breeding sites. Provinces with higher temperatures, rainfall, and proximity to breeding grounds tend to have higher malaria transmission rates.

Mosquito Vectors

The presence of mosquito vectors, such as Anopheles gambiae and Anopheles funestus, varies across the country. Different species predominate in different regions, with An. gambiae more common in forested hills in the north and An. funestus in central and southern regions. Vector distribution is influenced by factors such as rainfall, humidity, and human activities like agriculture and deforestation.

Population Displacement and Migration

Internal population displacement and cross-border migration also contribute to the spread of malaria. Angola's rapid population growth and urbanisation, particularly in Luanda, increase the risk of malaria transmission. Additionally, the recent severe drought in southern Angola may trigger population displacement and cross-border migration, potentially impacting malaria control efforts.

Drug Resistance and Counterfeit Medicines

The emergence of drug-resistant parasites and the availability of counterfeit anti-malarial drugs pose challenges to effective treatment. Monitoring drug resistance markers and implementing routine malaria information systems are crucial to address this issue.

Malaria treatment in Angola

Angola is a country with a high risk of malaria. The disease is transmitted by mosquitoes and is often fatal. The CDC recommends that travellers to Angola take prescription medicine to prevent malaria. The type of medication and when to start taking it should be discussed with a doctor.

Malaria is a major public health concern in Angola and is the biggest health threat to pregnant women and children under five. The entire population of Angola is at risk of contracting malaria, but the most vulnerable populations are children under five and pregnant women. In recent years, the Angolan government has invested in several malaria prevention interventions, including the distribution of insecticide-treated bed nets and indoor residual spraying. Despite these efforts, malaria remains a challenging public health burden in Angola.

To prevent bug bites, travellers to Angola should cover exposed skin by wearing long-sleeved shirts, long pants, and hats. They should also use insect repellent and sleep under a mosquito net if sleeping outdoors. If bitten by bugs, avoid scratching the bites and apply hydrocortisone cream or calamine lotion to reduce the itching.

Malaria statistics in Angola

Angola is one of the countries in which the entire population is at risk of contracting malaria. The disease is transmitted throughout the country, with 100% of the population at risk. The central and coastal provinces (Benguela, Bie, Cuanza Sul, Huambo, Luanda, Moxico, and Zaire) are mesoendemic with stable transmission, while the four southern provinces bordering Namibia have highly seasonal transmission and are prone to epidemics.

According to 2021 data from the Department of Epidemiological Surveillance and Hygiene of the Ministry of Health, malaria was the leading cause of low birth weight and anemia and was responsible for 42% of reported deaths. In the same year, 33% of all patients seeking healthcare were diagnosed with malaria, and 5.6% of all malaria cases were reported to be severe malaria, requiring hospitalization. Between 2020 and 2021, malaria case incidence remained stable at between 252 and 254 cases per 1,000 of the at-risk population. During this period, deaths rose by 16%, from 0.44 per 1,000 of the population at risk to 0.52 per 1,000.

Angola's National Malaria Strategic Plan recommends that all suspected cases of malaria be diagnosed using either microscopy or randomized control trials. The country has three alternative first-line ACT treatments: artesunate/amodiaquine (AS/AQ), artemether-lumefantrine (AL), and dihydroartemisinin/piperaquine (DP). The National Malaria Control Program recommends that severe malaria be treated with intravenous or intramuscular artesunate in facilities equipped to administer intravenous medications.

In recent years, the Angolan government, along with international partners, has invested in several malaria prevention interventions. By 2019, approximately 10 million Angolans (around 30% of the population) had access to insecticide-treated bed nets (ITNs), long-lasting insecticidal nets (LLINs), or indoor residual spraying (IRS). Despite these efforts, Angola continues to report outbreaks, particularly in the vulnerable province of Luanda, which is closely linked to high population density and inadequate sanitation.

Malaria in Angola vs. other countries

Angola is a country in Africa that has been experiencing a significant number of malaria cases and deaths. According to the Centers for Disease Control and Prevention (CDC), malaria is prevalent in Angola, and travellers to the country are at an increased risk of exposure. The CDC recommends that travellers take prescription medication to prevent malaria and consult their doctor about the appropriate malaria medication to take.

In 2019, a study was conducted among Asian migrants in Angola to understand their malaria prevention practices, knowledge, care-seeking behaviour, and infection prevalence. The study found that most respondents were aware of the presence of malaria in Angola and felt at risk. However, only a small percentage reported using chemoprophylaxis for prevention. Bed nets were the most commonly used form of malaria prevention, with 72% of respondents reporting bed net use.

The prevalence of current malaria infection among the surveyed Asian migrants was low, with 1-4% testing positive for malaria antigens. However, approximately half of the respondents had antibodies against Plasmodium, indicating past exposure to the parasite.

Angola has been facing a critical situation regarding malaria, with over 5,500 malaria-related deaths reported through May 2024, primarily in the provinces of Luanda, Lunda Norte, Malanje, Huambo, Uige, Benguela, Bie, and Huila. Children under five years of age and pregnant women are at the highest risk of mortality.

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