Sight Search

How to manage Malaria


Malaria is carried by thee female Anopheles mosquito and infection occurs following a mosquito bite and the injection of the insect’s saliva containing the malaria parasite into the wound. The disease occurs in many parts of the world and is caused by a parasite called Plasmodium. There are four species of Plasmodium, the most dangerous of these being Plasmodium falciparum.


Malaria usually presents initially with flu-like symptoms: headaches, muscle and joint aches, and fever. Severe shivering attacks (rigors) and high fever then occur and recur in a cyclical pattern every third or fourth day. In severe cases of Plasmodium falciparum malaria, the urine may become bloody (blackwater fever) or the brain may be affected with unconsciousness and convulsions (cerebral malaria).


No drug provides 100% cover against malarial infection. Prophylaxis must involve both mosquito avoidance and antimalarial drugs. Mosquito avoidance involves:
  •  meticulous application of insect repellent to exposed skin and clothing. The repellent of choice is N,N-diethyltoluamide (e.g. Peaceful Sleep, Mylol and Tabard lotions and sticks)
  •  wearing long-sleeved shirts or blouses, slacks and socks between sunset and sunrise (the feeding time of the Anopheles mosquito)
  •  moving continuously when outdoors at night (mosquitoes prefer a static meal)
  •  mosquito screening on all doors and windows
  •  spraying insecticide inside living quarters every day at dusk
  •  burning insecticide coils in the sleeping quarters at night
  •  sleeping under insecticide-impregnated mosquito nets tucked under the mattress.

Antimalarial drugs

The drug of choice depends on the area visited, the presence or absence of drug-resistant P. falciparum malaria, personal allergies and idiosyncrasies to antimalarial medication, drug interaction with any maintenance medication a diver may be using, pregnancy, age, health and the availability of the drug. Consult your doctor to determine the best choice of medication and to ensure that no untoward side effects or contraindications are present.

Chloroquine 150 mg tablet: In South Africa, with the exception of the Ingwavuma and Ubombo districts, all species of malaria are, to date, chloroquine sensitive. Preventative treatment should begin 24 hours before entering an endemic area. In adults and children over 12 years, two tablets are taken initially, repeated weekly on the same day while in the area, and then weekly for four weeks after leaving the area. Children aged six to 12 years take one tablet; aged one to five years take half a tablet (or 10 m syrup); aged six weeks to 12 months take 5 m syrup.

In areas where drug-resistant P. falciparum prevails (South-East Asia including Philippines, Thailand, Burma and China; Gabon and most of sub-Saharan Africa including the Comores and Madagascar; Sodwana; and the Ingwavuma and Ubombo districts of South Africa),
other antimalarial drugs are required.
  •  A doctor must always be consulted, if at all possible.
  •  Self-treatment of malaria: Divers in remote malarial areas and without access to immediate medical treatment may be faced with the problem of an unexplained fever, headache, body aching and rigors. Self-treatment is potentially very dangerous.

 If malaria is suspected and there is absolutely no professional help available use:
  • Coartem (artemether 20 mg, lumefantrine 120 mg) tablets. Take with food/fluids. Repeat dose if vomiting occurs within one hour of administration. An intensive three-day course is recommended. The dose depends on body mass. 

Children of 10-15 kg: one tablet initially, repeat after eight hours; thereafter one tablet twice a day for the following two days (total: six tablets). Children of 15-25 kg: initially two tablets as a single dose; repeat two tablets after eight hours and thereafter two tablets twice a day for the following two days (total: 12 tablets).
Children of 25-35 kg: initially three tablets as a single dose, repeated after eight hours; thereafter three tablets twice a day for the following two days (total: 18 tablets).
Persons of 35-65 kg: initially four tablets as a single dose, repeated after eight hours; thereafter four tablets twice a day for the following two days (total: 24 tablets).
For persons over 65 kg, the same dose (total: 24 tablets) is recommended.
With new or recrudescent infections, a second course is recommended.

  • Fansidar (pyrimethamine/sulphadoxine) as a single dose (three tablets for adults, two tablets for ages nine to 14, one tablet for ages four to eight; half a tablet for ages under four).

  • Coartem and Fansidar are temporary measures only and a doctor must then be found and consulted urgently.
  •  Safety in pregnancy and lactation has not been  established. Side effects have been reported and special precautions do exist. If at all possible, contact a doctor before using the treatment.


immersion and bubble formation Accidents Acid reflux Acute ailments After anaesthesia Air Quality Air exchange centre Air hose failure Airway control Air Alert Diver Magazine Alternative gas mix Altitude changes Altitude sickness Aluminium Oxide Ama divers Amino acids Anaerobic Metabolism Annual renewal Apnea Apnoea Aquatic life Archaeology Arterial gas embolism Arthroscopic surgery Aspirin Aurel hygiene BCD BHP BLS BWARF Back adjustment Back pain Back treatment Backextensors Badages Bag valve mask Bahamas Balancing Bandaids Barbell back squat Barometric pressure Barotrauma Basic Life Support Batteries Bench press Benign prostate hyperplasia Beth Neale Black Blood flow Blood thinners Blue Wilderness Blurred vision Boat safety Bone fractures Bouyancy compensators Boyle's Law Boyle\'s Law Bradycardia Brain Breast Cancer Breath Hold Diving Breath holding Breath hold Breath-hold Breathing Gas Breathing gas contamination Breathing Breathold diving Broken bones Bruising Bubbleformation Buddy Exercise Buddy checks Buoyancy Burnshield CGASA CMAS CO2 COVID-19 COVID CPR Cabin pressure Caissons diseas Camera settings Cancer Remission Cancer treatments Cancer Cannabis and diving Cannabis Cape Town Dive Festival Cape Town CapeTown Carbon Monoxide Carbon dioxide Cardio health Cardiological Cardiomyopathy Chamber Safety Chamber science Charging batteries Charles' Law Charles\' Law Charles\\\' Law Charles\\\\\\\' Law Charles\\\\\\\\\\\\\\\' Law Charlie Warland Chemotherapy Chest compressions Chiropractic Chlorophll Citizen Conservation Cleaning products Coastalexcursion Cold Water Cold care ColdWater Cold Commercial diving Commercial schools Compressed Air Compressed gas Consercation Conservation Contact lenses Contaminants Contaminated air Coral Conservation Coral Reefs Coral bleaching CoralGroupers Corals Core strength Corona virus Coro Courtactions Crohns disease Crowns Crystal build up Crystallizing hoses Cutaneous decompression DAN Courses DAN Profile DAN Researchers DAN medics DAN members DAN report DCI DCS Decompressions sickness DCS theories DCS DEMP DM training DNA DReams Dalton's Law Dalton\'s Law Dalton\\\'s Law Dalton\\\\\\\'s Law Dalton\\\\\\\\\\\\\\\'s Law Danel Wenzel Dauin island Dean's Blue Hole Deco dives Decompression Illness Decompression Sickness Decompression Stress Decompression illsnes Decompression treatment Decompression Deep diving Deep water exploration Delayed Offgassing Dental Diaphragms Diseases Dive Chamber Dive Computer Dive Destinations Dive H Dive Industry Dive Instruction Dive Instructor Dive Medical Form Dive Medical Dive Practices Dive Pros Dive Research Dive South Africa Dive Training Dive Travel Dive accidents Dive buddies Dive computers Dive excursions Dive fitness Dive gear Dive heallth Dive health Dive medicines Dive medicine Dive operators Dive planning Dive safety Dive safe Dive staff DiveLIVE Diveleader training Diveleaders Diver Health Diver Profile Diver infliencers Diver on surface Divers Alert Diving Divas Diving Kids Diving Trauma Diving career Diving emergencies Diving emergency management Diving fit Diving guidelines Diving injuries Diving suspended Diving Dizziness Dolphins Domestic Donation Dowels Dr Rob Schneider Drysuit diving Drysuit valves Drysuits Dyperbaric medicines EAPs EAP Ear pressure Ear wax Ears injuries Eco friendly Education Electronic Emergency action planning Emergency decompression Emergency plans Emergency underwater Oxygen Recompression Emergency Enviromental Protection Environmental factors Environmental impact Environmental managment Equalisation Equipment care Evacuations Evacuation Evaluations Even Breath Exercise Exhaustion Extended divetime Extinguisher Extreme treatments Eye injuries FAQ Factor V Leiden Failures Fatigue Faulty equipment Female divers Fillings Fire Coral Fire Safety Firefighting First Aid Equipment First Aid Kit First Aid Training First Aid kits Fish Identification Fish Life Fish Fitness Training Fitness to dive Fitness Flying Fractures Francois Burman Fredive Free Student cover Free diving Free flow Freedive INstructor Freedive Training Freediver Freediving performance Freediving Gas Density Gas consumption Gas laws Gas mixes GasPerformance Gases Gastoeusophagus Gastric bypass Gastroenterologist Gear Servicing Germs Gordon Hiles Great White Sharks Gutt irritations HCV HELP HIRA HMS Britanica Haemorhoid treatment Hazard Description Hazardous Marine life Hazardous marinelife Health practitioner Heart Attack Heart Health Heart Rate monitor Heart rates Heart rate Heart Heat stress Helium Hepatitis C Hepatitus B High temperatures Hip strength Hip surgery Hippocampus History Hot Humans Hydrate Hydration Hydrogen Hydroids Hydrostatic pressure Hygiene Hyperbaric Chamber Hyperbaric research Hyperbarics Hypothermia Hypoxia IdentiFin Immersion Immine systems In Water Recompression Indemnity form Indian Ocean Indonesia Inert gas Infections Infra red Imaging Injections Instinct Instruction Instructors Insurance Integrated Physiology International travel International Interval training Irritation Joint pain Junior Open Water Diver KZN South Coast Kidneys Kids scubadiver KwaZulu Natal Labour laws Laryngospasm Lauren Arthur Learning to dive Legal advice Legislation Lenses Leukemis Liability Risks Liability releases Liability Life expectancy Lifestyle Lightroom editing Live aboard diving Liver Toxicity Liver diseas Low blood pressure Low pressure deterioration Low volume masks Lung Irritation Lung function Lung injuries Lung squeeze Lung surgery Lung MOD Maintenance Malaria Mammalian Dive Response Mammalian effect Marine Biology Marine Scientists Marine conservation Marine parks Marinelife Masks Master scuba diver Maximum operating depth Medical Q Medical emergencies Medical questionaire Medical statement Medication Mehgan Heaney-Grier Mermaid Danii Mesophotic Middle ear pressure Mike Bartick Military front press Mixed Gas Mono Fins Mooring lines More pressure Motion sickness Mozambique Muscle pain Mycobacterium marinum Nausea Nautilus Neck pain Neurological assessments Nitrogen Narcosis Nitrogen build up Nitrox No-decompression Non-rebreather Mask Nonrebreather masks Normal Air Nosebleeds O2 providers O2 servicing OOxygen maintenance Ocean Research Ocean pollution Oil contamination Open water divers Optical focus Orbital implants Oronasal mask Osteonecrosis Out and about Outreach Oxygen Administration Oxygen Cylinder Oxygen Units Oxygen deficit Oxygen deicit Oxygen dificiency Oxygen ears Oxygen equipment Oxygen masks Oxygen supplies Oxygen supply Oxygen systems Oxygen therapy Oxygen P J Prinsloo PFI PJP Tech Part 3 Partner Training Philippine Islands Philippines Phillipines Photography Physioball Physiology Physiotherapy Pills Pistons Planning Plastic Pneumonia Pneumothorax Poison Pollution Pool Diving Post-dive Pre-dive Predive check Preparation Prepared diver Press Release Preventions Professional rights Provider course Psycological Pulmanologist Pulmonary Bleb Pulmonary Edema Pulse Punture wounds Pure Apnea Purge RAID South Africa RCAP REEF Radio communications Range of motion Rashes Rebreather diving Rechargeable batteries. Recompression chamber Recompression treatment Recompression Recycle Reef Conservation Reef surveyors Refractive correction Regulator failure Regulators Regulator Remote areas Renewable Report incidents Rescue Procedure Rescue breathing Rescue breaths Rescue training Rescue Resume diving Return to diving Risk Assessments Risk assesments Risk assessment Risk elements Risk management SABS 019 SafariLive Safety Stop Safety SaherSafe Barrier Salty Wanderer Sanitising Sara Andreotti Saturation Diving Save our seas Science Scombroid Poisoning Scuba Air Quality Scuba Injury Scuba Instructor Scuba children Scuba dive Scuba health Scubalearners Sea Horses Sealife Shark Protection Shark Research Shark conservation Shark diving Sharks Shoulder strength Sideplank Signs and Symptoms Sit-ups Skin Bends Skin outbreak Skin rash Snorkeling Snorkels Social Distancing Sodwana Bay Solomon Islands South Africa Spinal pain Splits Squeezes Stability exercise Standars Stay Fit Stents Step ups Stepping up Stroke Submerged Sudafed Sulawesi Supplemental oxygen Surface supplied Air Surfaced Surgeries Surgery Suspension training TRavel safety Tabata protocol Talya Davidoff Tattoes Technical Diving The Bends The truth Thermal Notions Tides Tips and trick Tooth squeeze Transplants Travel smarter Travel tips Travel Tropical Coastal Management Tunnelling Tweezers Ultrsound Umkomaas Unconsciousness Underground work Underwater hockey Underwater photographer Underwater photography Underwater pho University of Stellenbosch Urinary retention. Vaccines Vagus nerve Valsalva manoeuvers Vape Vaping Vasopressors Vasvagal Syncope Venting Virus infections Volatile fuels Washout treatments Wastewater Watchman device Water Resistance Water Weakness Weigang Xu Weights West Papua Wet diving bell Wetsuit fitting Wetsuits White balance Wide angles Winter Woman in diving Woman Women In Diving SA Women in diving Work of Breathing Workout Wound dressings Wreck divers Wreck dive Wreckdiving Wrecks Yoga Youth diver Zandile Ndholvu Zoology abrasion acoustic neuroma excision air-cushioned alert diver altitude anemia antibiotics anticoagulants antiseptics bandages barodontalgia bent-over barbell rows bioassays body art breathing air calories burn carbon dioxide toxicity cardiovascular cerebrospinal fluid checklist chemo port child clearances closed circuit scuba corrective lenses currents cuts dead lift decompression algorithms decongestants decongestion dehydration dive injuries dive medicing dive ready child dive reflex dive tribe diver in distress diver rescue diver training dive diving attraction doctors domestic travel dri-suits drowning dry mucous membranes dry suits dry e-cigarettes ear spaces elearning electrolyte imbalance electroytes emergency action plans emergency assessment equalising equalizing exposure injuries eyes fEMAL DIVERS fire rescue fitnes flexible tubing frediving freedivers gas bubble gas poisoning gastric acid gene expression health heartburn histidine hospital humidity immersion and bubble formation immersion pulmonary edema (IPE jaundice join DAN knee longevity lower stress malaise marine pathogens medical issues medical procedures medical risk assesment medications mental challenge micro-organisims minor illness mucous membranes nasal steroids nasal near drowning nematocysts neurological newdivers nitrogen bubbles off-gassed operating theatre operations orthopeadic outgas pain perforation phillippines physical challenges pinched nerves plasters polyester-TPU polyether-TPU post dive posture prescription mask preserve prevention psychoactive pulmunary barotrauma rebreather mask rebreathers retinal detachment risk areas safety stops saturation scissors scuba equipment scuba single use sinus infections smoking snorkeling. spearfishing sterilising stings strength sub-aquatic swimmers ears tattoo care tecnical diver thermal protection toxicity training trimix unified standards vision impaired warmers water quality