Global malaria levels decrease - but not in Belgium

In the five years from 2010 to 2015, malaria infections across the world dropped by 29%. Meanwhile the number of infected travellers coming back to Belgium – about 300 a year – is not decreasing. In fact it’s on the rise. Dr Ula Maniewski, from Antwerp’s Institute of Tropical Medicine, offers some possible explanations.

How did you notice this anomaly?

We get blood samples from laboratories all over the country to confirm the diagnosis of malaria, and we also see malaria patients in our travel clinic. In recent years, the number of cases we’ve confirmed at the institute have been increasing slightly.

What might the reasons be?

There are more travellers than ever before. But most importantly, there is a problem of perception, in that travellers underestimate the risk and the consequences of infection. In some regions the risk is rather low and only mosquito bite prevention is recommended, but in other regions – like most of the destinations in sub-Saharan Africa – the risk is still high and malaria prophylaxis is necessary. Some people might think a mosquito net and repellent are enough wherever they go, but actually they’re not.

What about African communities in Belgium?

African people who are living in Belgium don’t protect themselves when they visit their previous home because they didn’t when they were living there. Because of the time they’ve spent in Belgium, they’ve lost the partial immunity they used to have.

Do the anti-malarial pills have side-effects?

Some of the prophylaxes don’t have the best reputation. Some people do indeed suffer from side effects to some of the prophylactic agents, but certainly not everyone and not to all prophylaxes. These cases get generalised and this means some people decide not to use the medication.

How seriously should we take the malaria risk?

In this country a couple of people still die from the disease each year. Malaria starts just like an innocent flu, with chills, fever and pain in the muscles. Most people think they will get over it but, within a few days, complications can occur and might lead to death.

To anyone who has a fever within three months of returning from Africa, I would say: please go to the doctor immediately. Waiting a weekend might be too long.

Photo: Institute of Tropical Medicine in Antwerp