Biting back

Health Malaria remains a deadly threat in many parts of the world, but new advances are being made to find a solution to this mosquito-borne disease.

A good-quality insect repellent containing DEET is a must when visiting malaria-endemic regions.

It's a shocking statistic: every 30 seconds, a child dies of malaria. And across the world, more than a million people die from the infection every year, the majority of whom are infants, young children and pregnant women in Africa. The mosquito-borne disease, which with the right precautions and treatment is largely preventable and curable, still affects 40 per cent of the world's population, most of whom are also the world's poorest people.

But it looks like malaria's days as a feared killer may be numbered. This year, it was announced that the World Health Organization (WHO) is aiming to stop malaria deaths by 2015 by dramatically increasing research funding. In addition, a new vaccine is ready to start human trials next year. There are still plenty of phases of development to negotiate before it can be licensed, including field trials in Africa, according to The Jenner Institute at Oxford University, where it's being developed, but it's a significant breakthrough in that it is the first vaccine that has ever been shown to work in animals. Should it clear all the tests, it's expected to be available within 10 years, and will be a solution to one of the biggest killers of children in the world.

The future looks hopeful, but for now malaria remains a deadly disease, causing serious illness in more than 500 million people worldwide every year. The major danger zone is sub-Saharan Africa, but those travelling to Asia, Latin America, around the Middle East (but not the UAE) and parts of Europe are also at risk. So what should you do if you're travelling into a malarial zone? Before travel, you should go for a check-up, which will establish if you need additional injections before you go. To find out if you're travelling in a malaria-endemic region, there's an interactive map on www.malariahotspots.co.uk, which points out the main problem areas. Some areas are malaria endemic - they have fairly constant levels of malaria year-round - whereas others have different risks according to the season, rainfall levels and proximity to breeding grounds.

While the UAE is a safe zone, the Middle East in general will require you to be protected against malaria - so travel in nearby Saudi Arabia, Yemen and Iraq and right through to Turkey, Iran, India, Pakistan, Afghanistan, Sri Lanka, Nepal, Bangladesh and Tajikistan will require malarial protection. You're most at risk if you hail from a malaria-free region - like the UAE, the UK and America - and are visiting areas where there is malaria transmission, because you won't have any natural immunity. Pregnant women are also at high risk of severe illness, impaired foetal growth or foetal loss and death should they contract it.

But this does not mean that if you grew up in a malarious area, you do not need to take precautions. Many people wrongly assume that because they used to live in a malarious country, they are immune, and many cases of malaria are seen in people who return to their country of origin to visit friends and family. Larry Goodyer is a spokesman for the Malaria Awareness Campaign and the head of the school of pharmacy at DeMontfort University in the UK. He explains: "If you come from an area with the most dangerous form of malaria, Plasmodium falciparum, it will kill many people in childhood. If you are exposed to it and you survive, you develop semi-immunity. But if you leave the country and go to work in a place like Abu Dhabi where there is no malaria, that immunity will wane. When you return, you will be just like any other traveller."

How long immunity takes to wane varies from person to person, but Goodyer's advice is that after an absence of anything more than a few months - essentially anything longer than regular tourist travel - you should assume you have lost immunity and take appropriate precautions. The medication situation is far from simple. The combination of Chloroquine and Paludrine (also called Proguanil) is widely suggested for areas with a low risk of malaria, for example India and the Far East.

But there are strains of malaria resistant to this drug combination, particularly in sub-Saharan Africa, so the alternative, Lariam, is suggested. It isn't without its side effects - the drug is known to occasionally produce strange dreams, mood changes and hallucinations. These side effects usually appear by the third dose, so starting treatment before travel is essential. While many branches of alternative medicine, such as homeopathy, offer remedies that some people claim can prevent malaria, it is important to note they have never been tested and there is no evidence that they are effective at preventing a potentially fatal infection.

A spokesman for the National Center of Malaria Control in Sharjah said: "We would prescribe chemical prophylaxis for any traveller going into a malarial zone. Typically, these tablets have to be taken a week before travel, weekly while away, and four weeks after their return." He also commented that travellers should seek advice before they depart from the National Center of Malaria Control (06 563 8811) and that they can advise on all issue pre- and post-travel in a malaria-endemic area.

Even if you are taking prophylactic drugs, it makes sense to take precautions to avoid getting bitten as well - wearing long-sleeved tops and trousers and socks in the dusk and evening helps, as does using insect repellents containing DEET that have proven effectiveness. On your return from a malaria-endemic area, delays and mistakes in diagnosis can be very dangerous - so be aware of the symptoms.