Malaria prevention for seafarers
Understanding Malaria Risks for Seafarers: An In-Depth Look
Introduction to Malaria Risks at Sea
Malaria is one of the deadliest diseases worldwide, spread by infected Anopheles mosquitoes. Each year, it kills approximately 400,000 people. Seafarers, especially those on long voyages through tropical regions, are at high risk of contracting malaria. This is particularly challenging as many commercial ships lack onboard doctors, which complicates the management and treatment of this disease. A study conducted by Graziano Pallotta, Marzio Di Canio, Stefania Scuri, Francesco Amenta, and Giulio Nittari titled “First surveillance of malaria among seafarers: evaluation of incidence and identification of risk areas,“ published in Acta Biomed in 2019, highlights these risks and emphasizes the need for better preventative measures and health resources on ships.
What the Study Found
This study looked at over 17,000 health records of seafarers on commercial ships that received medical help from the International Radio Medical Centre (CIRM) between 2011 and 2015. The research reviewed both confirmed and suspected malaria cases, and it examined how these cases were spread around the world. Additionally, it analyzed the medications available on these ships for treating malaria.
Key Findings on Malaria Cases and Risk Areas
While malaria cases dropped slightly over the five years, it still accounted for a large share of infectious diseases reported onboard. Some key findings from the study include:
- In 2011, confirmed malaria cases made up 33.75% of all infectious diseases reported.
- This number rose to 41.67% in 2012, showing a steady concern about malaria risk.
- The highest-risk areas included the West African coast, where malaria is common, especially the dangerous strain, Plasmodium falciparum.
Malaria Symptoms and Dangers
Malaria often begins with mild symptoms, such as fever, chills, headache, and muscle pain. However, it can quickly become severe, with symptoms like:
- Kidney failure
- Fluid in the lungs
- Seizures
- Circulatory collapse
- Coma or death if untreated
Challenges in Preventing and Treating Malaria for Seafarers
Seafarers face numerous challenges in preventing and managing malaria while at sea. Most commercial ships lack onboard medical personnel, meaning crew members must rely heavily on remote medical assistance from services like the International Radio Medical Centre (CIRM). These services can help assess symptoms remotely and recommend immediate laboratory tests upon the ship’s arrival at the nearest port to confirm suspected malaria cases. However, the time delay in receiving direct medical care can complicate the early diagnosis and timely treatment of malaria, making effective onboard solutions essential.
Limited Medical Supplies Onboard
A significant issue highlighted by the study is the insufficient availability of standardized medical supplies for malaria treatment. Many ships lack adequate anti-malarial drugs, such as Malarone, which is recognized for its effectiveness against drug-resistant malaria strains. Without these essential medications, treating malaria symptoms becomes challenging, especially if a ship is far from port. Enhancing the standardization and accessibility of such critical medications and supplies onboard could play a key role in improving malaria outcomes and ensuring better health safety for seafarers in high-risk areas.
Recommendations for Protecting Seafarers from Malaria
To reduce the risk of malaria, the authors suggest improving prevention and treatment strategies. Some important steps include:
1. Strengthening Prevention Measures
Seafarers should use mosquito repellents, wear long-sleeved clothing, and sleep under mosquito nets when traveling through malaria-risk areas. Taking these precautions reduces exposure to mosquito bites, which are the primary way malaria is transmitted. Additionally, seafarers should be trained to recognize high-risk areas and advised to minimize time spent outdoors during peak mosquito activity periods, typically around dusk and dawn.
2. Preventive Medications
Before entering malaria-prone areas, seafarers are advised to start taking preventive medications. According to the World Health Organization (WHO), Malarone is the recommended drug due to its effectiveness against Plasmodium falciparum and other resistant strains of malaria. These medications should be taken as directed, both before and after leaving malaria-risk zones, to ensure continuous protection. Regular medical check-ups can also help monitor any side effects of long-term prophylactic medication use.
3. Standardized Medical Kits on Ships
The study suggests that ships should carry standardized medical kits containing essential malaria medicines and diagnostic tools. These kits should include medications like chloroquine, artemether, and Malarone, which are effective in treating malaria. Having diagnostic tools onboard, such as rapid malaria test kits, enables quick detection and treatment, reducing the risk of complications from delayed care. Ensuring that these medical supplies are regularly updated and replenished will also improve preparedness on ships traveling through malaria-endemic regions.
Conclusion
In summary, malaria remains a serious health risk for seafarers, especially those traveling in high-risk areas. Although cases have decreased, malaria still demands attention due to the unique challenges of shipboard environments. Strengthening preventive measures, ensuring access to preventive medications, and providing standardized medical kits with essential antimalarial drugs are key steps. These measures offer seafarers better protection against malaria, supporting their health and safety while at sea.
