Gauteng health practitioners are sounding the alarm after 414 malaria cases and 11 deaths were recorded in just three months, a sharp rise in a province not traditionally malaria-endemic, where infections are usually linked to travel.
The figures are already approaching, and in some measures surpassing, last year’s total, raising concerns about missed diagnoses, delayed treatment and limited awareness among both patients and healthcare workers.
Clinical practitioner Katlego Ngobeni described the trend as “highly concerning,” warning that Gauteng may be entering a more dangerous phase if prevention and early detection are not strengthened.
“From a clinical perspective, this rise is highly concerning. Gauteng is not a traditionally malaria-endemic province, which makes the emergence of 11 deaths within such a short period particularly alarming,” Ngobeni said.
“It suggests both increased transmission risk and potential gaps in prevention or early detection. If the public does not take preventive measures seriously, we could see a significant escalation in both cases and fatalities as the year progresses.”
Ngobeni noted that the province is already nearing and, in some comparisons, exceeding 2025 figures, where 666 cases and 9 deaths were recorded over the full year.
“In just the first quarter of 2026, the province has already exceeded last year’s toll and reached approximately 62% of the total cases. This trend is deeply concerning and signals a potentially worsening public health situation.”
He added that one of the key challenges is that malaria symptoms often resemble common viral illnesses, leading to misdiagnosis or delayed treatment.
Symptoms include fever, chills, headaches, nausea and vomiting, night sweats, muscle fatigue, dry cough, and in severe cases, yellowing of the eyes and pale skin.
“Particularly if you recently travelled to or been in contact with a person who travelled to a malaria-endemic area, these symptoms should not be ignored,” Ngobeni warned.
He said malaria is often not the first condition suspected in non-endemic provinces like Gauteng, which can delay testing and treatment.
Ngobeni also highlighted the incubation period, which can range from two weeks to several months, as a major factor complicating diagnosis.
“Symptoms do not appear immediately after infection. This delay often leads to patients seeking medical care later in the course of the illness, by which time the parasite may have already caused significant harm,” he said.
“As a result, many patients present with advanced or complicated malaria, which is much more difficult to manage and increases the risk of death.”
He warned that late presentation often means the disease has already progressed to severe complications affecting multiple organs.
While Gauteng’s health facilities are generally equipped to diagnose and treat malaria, Ngobeni said early detection remains a critical gap.
“From a clinical standpoint, healthcare facilities in Gauteng are generally equipped to diagnose and manage malaria, particularly at district, regional and tertiary levels. However, early detection can still be a challenge because clinicians may have a lower index of suspicion in a non-endemic province.”
According to the Gauteng Department of Health, the spike in cases has been linked to increased travel during the festive season, when many residents visit malaria-endemic regions and return after potential exposure.
The department said the upward trend reflects heightened transmission risk in the early months of the year following holiday travel.
“The upward trend signals heightened transmission risk, particularly in the early months of the year after the festive season, when many residents travel to malaria-endemic areas,” the department said.
Residents have been urged to seek immediate medical attention if they experience symptoms such as fever, chills, headache and fatigue, especially after travelling to high-risk areas including Limpopo, Mpumalanga, Mozambique, Zimbabwe and Malawi.
The department also stressed that prevention remains key in curbing infections, adding that protective measures such as insect repellent and protective clothing should be consistently used.
anita.nkonki@inl.co.za
Saturday Star