Travel to the coast by highlanders and its implications for malaria control

Three groups of highland subjects were questioned about malaria and their visits to coastal areas: patients admitted to Goroka Base Hospital with malaria, patients admitted with diagnoses other than malaria who had visited the coast within the previous six months, and health staff working in Goroka. Nearly a third in all groups reported having had two or three attacks of malaria. 82% of malaria patients had visited the coast in the previous 4 weeks compared to 26% of patients without malaria. Most malaria seen in Goroka is imported from the coast. Most patients in the survey came from rural areas and were uneducated. However, health workers also failed in most cases to take adequate precautions when they visited the coast. It is suggested that a malaria prophylaxis station should be set up at the gateway to the highlands on the Highlands Highway, where malaria education and the means for chemoprophylaxis and protection from mosquitoes could be made available for all travellers.