Southern Africa
Travel To Southern Africa
* Botswana * Lesotho * Namibia * South Africa * Swaziland * Zimbabwe
Vector-borne infections are common in parts of the region. Access to clean water and sanitary disposal of waste are highly variable but are poor in some areas (especially some rural areas). Vaccine coverage is high in some populations, but vaccine-preventable diseases, such as measles, mumps, rubella, and diphtheria, persist in parts of the region. Polio reappeared in 2004 in Botswana. More common infections in travellers include gastrointestinal infections, African tick-bite fever, and malaria. Infections in immigrants (and long-term residents from the region) include tuberculosis, HIV, schistosomiasis, and intestinal parasites.
Vector-borne infections: Malaria is present in parts of all countries in the region except Lesotho, although the risk is focal or seasonal in many areas. African tick-bite fever (Rickettsia africae) has been common in travellers to the region, especially South Africa, Botswana, Swaziland, Lesotho, and Zimbabwe. Other vector-borne infections include tick-borne relapsing fever, Rift Valley fever*, dengue (focal outbreaks but larger areas infested with Aedes aegypti), tick-borne relapsing fever, murine typhus, West Nile fever, and Crimean-Congo haemorrhagic fever*. African trypanosomiasis has been reported from Botswana and Namibia in the past. Tungiasis is reported from South Africa.
Food- and water-borne infections: Risk for hepatitis A is high in parts of region; outbreaks of hepatitis E have been reported. Risk for dysentery and diarrhoea is highly variable within the region. Diarrhoea in travellers may be caused by bacteria, viruses, and parasites. Other risks for travellers include typhoid and paratyphoid fever and amoebiasis. Cholera is sporadic and epidemic (epidemics since 2002 in South Africa, Swaziland, and Zimbabwe). Intestinal helminths, though common in some local populations, are rare in short-term travellers.
Airborne and person-to-person transmission: The estimated incidence rate of tuberculosis is >300 per 100,000 population in the region.
Sexually transmitted and blood-borne infections: HIV prevalence in antenatal clinics exceeds 25% in many countries in region. Prevalence of chronic carriage of hepatitis B virus exceeds 8%.
Zoonotic infections: The mongoose is a source of rabies in addition to domestic dogs and other animals. Plague* is enzootic, and sporadic cases and outbreaks have occurred in Botswana, Namibia, and Zimbabwe since 1990. Anthrax* is hyperendemic in Zimbabwe, with recent outbreaks in animals and also human cases. Sporadic cases of anthrax have been reported elsewhere in the region.
Soil- and water-associated infections: Focal active areas of schistosomiasis persist (caused by Schistosoma mansoni, S. haematobium, and S. mattheei). Cutaneous larva migrans can occur after exposures on beaches. Leptospirosis* has caused outbreaks. Histoplasmosis has caused an outbreak in South Africa.
Other hazards for travellers include motor vehicle accidents and violent injury, as well as snake bites. Screening of blood before transfusion is inadequate in many hospitals.
