Only one region of South Africa is in a malaria risk area and that is the Kruger National Park and Sabi Sand Reserve region, commonly referred to as the 'Lowveld'. The risk is usually low however. Historically there have been incidences of malaria in other regions of South Africa, but then there are recorded incidences of malaria from urban Europe and other non-risk areas. To all intent and purposes the Lowveld is the only malaria risk region in South Africa.

The threat of malaria should not affect your decision to enjoy and experience the Kruger Park or the Sabi Sand Reserve, but is just something one should be aware of and take the relevant precautions.

Anti-malaria prophylactics are thus recommended when visiting the Kruger Park and the Sabi Sand Reserve. The highest risk period is between December and April (end of the rainy season). A 24-hour malaria hotline is available on +27 (0) 82 234 1800 to give detailed explanation on risk and advice on precautionary measures. Visitors wishing to take prophylactics should consult a knowledgeable medical practitioner or recognized travel clinic about recommended medication, as certain products cause nausea, hallucinations or other negative side effects with certain people.

Very often (particularly after periods of low rainfall) the malaria risk in Kruger and Sabi Sands is very low. Many people decide not to take prophylactics and rather try to avoid getting bitten. The most vulnerable times are between dusk and dawn. People are advised to stay indoors during these periods, or cover exposed skin with light clothing or insect repellents. The ankles are the most critical area. Burning anti-mosquito coils and ensuring netted screens are kept closed are other preventative measures.

While malaria prophylactics are recommended, no prophylactic is foolproof and any person developing flu-like symptoms 7 to 20 days (or even longer) after being in malaria areas should be tested immediately for malaria, until the symptoms clear or an alternative diagnosis is made. It is important to advise medical practitioners that you have been in a malaria area to avoid incorrect diagnosis.

On the question of prophylactics, no drug is guaranteed 100% effective, but a combination of choroquin (taken weekly first one week before) and paludrin (daily - first 2 days before) appears to be the most recommended prophylactic.  Mefloquin is a single alternative.  These would be available from pharmacies in Johannesburg and en route to the park in Nelspruit (and perhaps for sale at some of the larger rest camps in the park).  However as they should be taken a week in advance, if one chooses to use them, buying them in SA would be leaving it late, unless you will be spending time elsewhere in the country (most of which is malaria free).

NB: Most types of mosquito do not carry the malaria plasmodium and if one is bitten it does not mean one will contract malaria.  Only mosquitoes of the anopheles genus carry the plasmodium, and then only if they have previously fed on an infected host.  As the presence of people with the plasmodium in their bloodstream in the park is greatly reduced compared to past times, risk is once more reduced.  One reason for these reductions is that the accommodation units in the parks are sprayed periodically throughout the year.  Now that international campaigns are ensuring treatment is taking place in adjacent countries such as Mozambique and Swaziland, malaria occurrence has been further reduced.