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I'm considering some trips to Africa at some point in the future and a major concern is protecting against illness.

Obviously, as with other places, the continent varies a lot: cities, rural, villages. So the advice would vary as risks will be low in some areas and high in others - as is the case on other developing continents.

And don't get me wrong I'm not singling out this content as being the only one where one should be careful, this would apply to other regions where such risks can occur.

Taking official advice on vaccinations is fairly straightforward and advice on Malaria is well documented (but any points welcome).

My Specific Question

My question is more about other risks. It is perhaps easy to get carried away with over concern about these, particularly as many are quite unpleasant, e.g. parasites in the gut, legs, eyes etc. Various TV programmes and websites can scaremonger. But how much of a risk are these really?

I regard travel.stackexchange.com as quite a high quality forum, where the signal to noise ratio is very high and comments are generally sensible. So I'm looking to see how contributors could answer my question. The decision on risk is ultimately mine of course.

As this site guides questioners to ask solvable questions, then my question is can you provide definitive advice on the risks:

  • what risks are current
  • where do they occur (rural, urban, semi rural, regions?)
  • preventative steps ( vaccinations, avoidance of certain foods (e.g. veggie only, wash foods, hygiene, boil/steriliser tablets to make water safe to drink)
  • symptoms to look for
  • treatment (though I'd prefer not to get to this stage :) )

Some research I have done so far:

Parasites: how acquired, symptoms and remedies:

(If I'm honest this is the kind of thing I'm most concerned about, perhaps a moderate phobia of, I don't think I'm alone in that. Apart from the risk itself, I think my attitude is also something would have to consider).

Delicious.com stack: http://delicious.com/stacks/view/TelRyi

Some seemingly good advice:

Others (fairly thought provoking, if sometimes unpleasant stories, a bit more anecdotal):

Malaria:

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    This question seems like it might perhaps be too large in scope
    – Casebash
    Mar 1 '12 at 23:52
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Obviously it depends on where you go, and when you go.

Different areas have different bugs, there is the malaria belt, and you'll need Yellow Fever vaccinations for some countries.

The simplest answer to all this, especially if you're paranoid: be as prepared as you possible can.

What this means:

  • Have all appropriate vaccinations. This includes the essentials, the recommended, and asking if they have any other fun ones in the back you could get while you're there. Rabies for example, is hardly ever suggested, but can be useful, and if you're getting jabbed anyway, why not?!

  • Have a medicine kit. Not a simple buy-from-your-supermarket one, but a proper one with bandages, splints, etc.

  • Ask your doctor if he's prepared to give you a run of antibiotics in advance. If you get really sick somewhere they may not be available, and you could start on your emergency run immediately!

  • Sunscreen, mosquito nets, long but light sleeves, a hat - so simple, but so many don't have them!

  • All those 'incidental' but really really useful medicines - paracetomol/aspirin (painkillers), anti-vomiting, immodium (for traveller stomach), anti-itch cream for when bitten, anti-septic ointment for cuts / scrapes.

  • Sexual protection, if you're planning on engaging in any of that activity.

  • Surgical gloves in your medicine kit

  • Learn basic CPR and first-aid skills

  • Anti-bacterial wipes/spray for your hands before you eat etc

  • Let friends/family know your route, plans, schedule.

  • Bring any medical records you have. It'd be terrible for a doctor to unknowingly give you a medicine which clashed with something you have or had been on, or were allergic to.

  • research and print locations and contact details for doctors and hospitals in the areas you're going. It's soo much easier to do online from the comfort of your own home, than when you're feeling sick and on the road with limited internet access!

When there:

  • Always check the meat, that it's freshly and properly cooked.

  • Perhaps avoid the salads/vegetables if they've been washed in the local water.

  • Always boil local water. Even use chemicals to kill bugs if you want (you can buy cannisters of the stuff)

  • Apply common-sense.

Malaria

We have a great page on what happens with malaria itself!

Other disease - there are so many symptoms that they're too many to list here. The most important thing is to listen to your body - it'll tell you if there's a problem. But with most of them, common signs of anything being wrong will include one or more or all of: headache, diarrhea, faintness, shortness of breath, coughing, unusual tiredness, spots in front of your eyes, loss of appetite, temperature (look for shivering), discoloration of the skin, unusual lesions or lumps, swelling - basically, something is wrong = could be a sign! ;)

While there are doctors in all countries, their skill, language abilities and knowledge will vary dramatically (I was made very aware of this in Tajikistan). Check online, sometimes there's an international hospital or doctor, and these can be the most use as they'll have valuable information and often drugs for people more susceptible to disease: foreigners like us ;)

In the end, it's a bit of a lottery anyway. I've been to about 10 countries in Africa, and the only one I had stomach issues on was an organized, sanitized tour of Egypt. Everywhere else I was fine.

But remember, this is Africa you're aiming for! Land of the wide horizon, great sunsets, abundant wildlife, and landscape as old as time itself. Take some risks, odds are that the rewards will far outweigh the risks themselves.

EDIT

Parasites

To add some more information, I found a great if slightly... ok VERY disturbing read on how to avoid getting parasites. Essentially it comes down to the same - don't eat raw meat, etc etc, but there's some good specific information there too.

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    +1 @Mark Mayo. Good advice. I'll leave it open for a bit longer before accepting an answer. Thanks!
    – therobyouknow
    Jan 10 '12 at 9:33
  • Thanks again these are great points, including the points on food hygiene to avoid illness - I accept that for these, those step are the best one can do, and that it is about reducing the risk. But I would welcome thoughts on how far one can avoid acquiring parasites through being bitten for example. I remember watching a TV prog where a chap had a tiny worm wriggling across the clear part of his eye. I think he was treated successfully but it took about at least a year for it to manifest. As said in my question, I'm looking to be informed as to how much these really are a risk, if at all.
    – therobyouknow
    Jan 10 '12 at 10:17
  • (to clarify, a year for it to become obvious he had the creature, before it decided to reveal itself in the clear part of his eye). thoughts welcome.
    – therobyouknow
    Jan 10 '12 at 10:28
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    Accepted and many thanks. I'll keep reading around the subject and add anything else useful.
    – therobyouknow
    Jan 10 '12 at 12:44
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    have added a great link on how to avoid parasites specifically.
    – Mark Mayo
    Jan 11 '12 at 1:24
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Mark gave a pretty comprehensive answer, but I'll add my thoughts as well.

Know where you are going. This doesn't just mean what country you are going to, but a pretty decent idea of your itinerary, and any side trips you have planned. By way of example, a visit to Uganda that involves both a visit to Lake Victoria and some time visiting the Gorillas in the highlands has three utterly different disease risks associated with it.

Talk to your travel doctor. They should be able to give you an idea of what your risks are, and what preventive steps you can take.

Know where your embassy is. This is one you should know anyway going to Africa for all kinds of reasons, but if you find yourself in need of medical help, without a command of the local language or knowledge of the health system, the embassy for your native country could come in handy.

Be Cautious. Get your vaccinations. All of them. Ask your travel doctor if they'd be willing to prescribe you a course of antibiotics useful against a broad range of pathogens - this is especially helpful for the inevitable food related mistake. If something looks sketchy, don't eat it. Don't engage in the commercial sex trade in Africa. Seriously, just don't. Avoid things that can't be peeled or cooked all the way through. This includes (perhaps especially) things like salads and leafy greens. Everyone thinks about meat, but a huge number of GI illnesses can be traced to vegetables.

Don't necessarily trust "nice" places to be problem free. And yes, the TV shows are scary, but consider that they're talking about the disease burden of an entire continent. I could make a pretty scary TV show about North American diseases if I was so inclined. Flesh eating bacteria, horrible respiratory diseases, a good hemorrhagic fever or two, brain eating proteins lurking in meat, Black Plague...

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    +1 @EpiGrad this is great additional advice. Talking to a travel doctor is a good one, some might say one of the first things to do, but good advice nonetheless and I'm not going to shun that. TV shows: I agree with your point, one needs to keep things in perspective.
    – therobyouknow
    Jan 11 '12 at 2:15

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