There are a plenty of diseases occuring in this continent that do not exist or do not occur often in North-America or Europe so visitors have to take precautions and protect themselves against these diseases. Luckily, most diseases can be prevented with vaccinations, pills or just common sense.
Malaria

This disease is probably the most known African disease. However, there are also risks in some parts of Latin-America and Asia. It’s a parasitic disease caused by Plasmodium Falciparum or Plasmodium Vivax. It’s preventable by protecting yourself against mosquitoes with a repellent The most effective repellent contains DEET with 50% or more. The best option is to use 100%. If you use DEET watch out for your clothes as they may lose colour or your plastic material, like cameras. A mosquito net is neccesary to protect you at night as DEET will not protect you anymore after a few hours.
Before you enter a malaria-endemic zone you should visit a doctor that can prescribe you malaria prevention drugs. These drugs are anti-parasitic and may protect you from infection. There is still up to 20% chance to get infected! Depending on your personal choice, you can choose which medicine you prefer to take. I’ve listed the options below with the possible side effects.
| Option |
Dose |
Side Effects |
| Atovaquon (Malarone) |
1 Tablet every day
1 day before entering zone
7 days after leaving zone |
Mild effects like nausea, coughing, headache, …
Very uncommon: hair loss |
Mefloquine (Lariam)
Note: Resistance! |
1 Tablet every week
3 weeks before entering zone
4 weeks after leaving zone |
1/250 have serious side effects – Psychosis, Hallucinations, anxiety, … |
| Doxycycline (Antibiotic) |
1 Tablet every day
1-2 days before entering zone
4 weeks after leaving zone |
Very uncommon: photosensitivity, nausea, … |
Comments
- Atovaquon is a good option for malaria prevention because it has less side effects and you only need to take it 7 days after leaving the endemic zone. The only disadvantage here is the price. Atovaquon medicine is the most expensive option.
- Melfloquine is not a good option. Some endemic areas in Asia and Latin America have reported resistance against this drug. On top of that the medicine is expensive and some people get serious neurological side effects from it.
- Doxycycline is another good option because of the less side effects and the good effectiveness. It is also an extremely cheap option. You just have to take 4 weeks doxycycline every day after leaving the area.
Malaria is rare in North and South African countries.
Yellow Fever
This serious disease is caused by a virus and transmitted by mosquitoes so the same prevention as Malaria applies here.
Unlike Malaria there is a vaccination for this virus. You need to get this vaccination in a listed hospital so you can receive a certification. The Yellow Fever Certificate is obligated in some countries, especially if you come from an endemic zone. The prevention is important as the mortality rate is 20% for the people who have serious symptoms (fever, jaundice caused by liver damage, eye -, mouth - or intestinal bleedings). If you’d like to know if a country obligates the certificate, check the the list of countries by World Health Organisation (WHO) that require Yellow Fever Certificate.
Hepatitis A and B
HAV and HBV cause the disease. These are liver inflammatory diseases and can cause liver cirrhosis. In some cases, it is fatal so prevention is important. There are for both viruses a vaccination that can protect you for over 20 years. HBV vaccination is only one injection. The HAV vaccination boost has to be given six to twelve months after the first injection.

Hepatitis A can be transmitted by fecal-oral route. This means that the disease occurs at overcrowded places and locations with poor sanitation. The virus is resistant against temperatures, acidic en organic liquids so outbreaks in restaurants may occur. It can survive for months in water (even salt water) so vaccination is important when visiting African countries!
Hep. B is transmitted more by blood-containing fluids. So blood-blood contact, re-used needles and semen may cause infection. This means that infection may be prevented if you take extra cautions. Most Europeans are already vaccinated as a child for Hepatitis B.
Dengue Fever
Like Malaria, it is transmitted by a mosquito. Mosquito protection is very important to prevent you against numerous diseases especially for Dengue, because there is no other prevention and Malaria drugs are not waterproof. The main symptoms include fever, muscle and joint pains, a skin rash, … . The mortality is 1% even after treatments. Dengue does not only occur in African countries, but also in South-American and Asian countries.
Dengue is rare in North and South African countries.
AIDS

AIDS is still a big problem in Africa. It can be transmitted by blood contact or sexual contact and is caused by HIV. The best way to protect yourself against the virus is by using a condom. The disease is very serious so prevention is important. The disease can cause tumours in several organs and makes you more vulnerable to other diseases. So far there is no vaccination. Patients need to take antiviral drugs their whole life to slow down the progression of the disease.
Sleeping Sickness
Sleeping Sickness, also called African Trypanosomiasis is a disease caused by a parasite. The Tsetse fly is responsible for the transmission to humans but it can be transmitted by blood transfusion and sexual contact too. The disease is endemic in whole Africa except North-Africa. As soon as the parasite passes the blood-brain barrier it will cause neurological symptoms like wakefulness at night and sleepiness at daytime. Other symptoms include tremor, confusion, muscle weakness, Parkinson-like movements, and so on… If left untreated it may cause coma or death. Neurological damage is irreversible.

The only way to protect yourself against this disease is by preventing to get bitten by the fly. You can wear something with long sleeves and avoid bare skin.
Cholera
This bacterial infection causes diarrhoea and vomiting. The transmission happens through contaminated food or water (fecal-oral route). The symptoms can quickly cause dehydration and electrolyte imbalance which can lead to death. There is treatment with rehydration therapy and antibiotics. However, it is better to prevent yourself; there are vaccinations available. If you did not get vaccinated you can still reduce the risks by treating your drinking water (boiling, chlorination, …).
Schistosomiasis
This serious parasitic disease, better known as Snail Fever occurs in places with poor sanitation. Infection happens through contaminated water by larvae that penetrates the human skin. The mortality rate is low but it’s a chronic disease that may lead to some serious symptoms: enlargement of liver and spleen, bloody diarrhoea, hypertension, increased risk for bladder cancer, … . There’s treatment but prevention is more important of course, however you cannot really prevent yourself – the only option is to not swim in lakes or rivers. Swimming pools treated with chlorine or salty water is safe. Popular endemic waters in Africa are Lake Victoria, Nile River, Omo River, Zambezi River, Lake Malawi. The disease also occurs in Asia and South-America.
Tuberculosis
TB is in many cases a lethal infectious disease caused by mycobacteria. The disease attacks the lungs which causes sneezing and coughing (blood). The transmission of the bacteria is by air from infected persons. There is no real prevention, except by avoiding to come close to sick people. Treatment is difficult and requires dosing multiple antibiotics for a long period (over 6 months).
Conclusion
Most tropical diseases cause a fever. If you have a fever on vacation or after returning from a tropical country you should always suspect a tropical disease and go to the hospital.