Malaria cases have increased across parts of southern Africa following unusually heavy rainfall and recent flooding, creating more favourable conditions for mosquito breeding and malaria transmission. This seasonal rise has also resulted in an increase in malaria cases detected in South Africa, including in provinces where malaria is not normally transmitted.
In the first three months of 2026, Gauteng recorded 414 confirmed malaria cases and 11 deaths. While these figures are concerning and require increased public awareness and prompt healthcare action, most of these cases are imported. This means the infections were acquired in the malaria-endemic regions of Limpopo, Mpumalanga, and KwaZulu-Natal provinces, or through international travel to malaria-endemic locations, and diagnosed after individuals returned to the Gauteng province.
In South Africa, malaria transmission is mainly confined to the low-altitude areas of KwaZulu-Natal, Limpopo, and Mpumalanga, where malaria-transmitting mosquitoes occur and environmental conditions support ongoing transmission. Provinces such as Gauteng are not considered malaria-endemic, but imported malaria cases are frequently identified, particularly among travellers returning from affected areas within South Africa and elsewhere. In areas like Gauteng, where malaria-transmitting mosquitoes do not occur, people infected with malaria cannot transmit malaria to others.
Recent heavy rains and flooding across the region have increased malaria risk in endemic provinces in South Africa. For example, Mpumalanga alone reported more than 300 cases in January 2026, while neighbouring malaria-endemic countries have also seen a rise in infections. These conditions highlight the importance of heightened awareness, especially during and after the rainy season.
Malaria is both preventable and treatable, but it can progress rapidly to severe illness and death if diagnosis and treatment are delayed. Travellers to malaria-endemic areas should take preventive measures seriously, including the use of appropriate malaria chemoprophylaxis for moderate- to high-risk destinations. Anyone who develops flu-like symptoms such as fever, chills, headache, body aches, or fatigue after recent travel to a malaria-endemic area – whether within South Africa or elsewhere in Africa – should seek medical attention immediately and request a malaria test. This applies even to those who have taken preventive medication, as no prophylactic is 100% effective. Early diagnosis and prompt treatment save lives.
For additional guidance on malaria prevention, symptoms, and treatment, click here.
