By Momodou Janneh

On June 30, 2025, The Gambia’s Ministry of Health issued an advice on health hazards associated with the rainy season as follows:

Malaria is a life-threatening disease spread to humans by some types of mosquitoes. It is mostly found in tropical countries, according to the WHO. It is preventable and curable. A parasite causes the infection and does not spread from one person to another. Symptoms can be mild or life-threatening. Mild symptoms are fever, chills, and headache. Severe symptoms include fatigue, confusion, seizures, and difficulty breathing.

Globally in 2023, there were an estimated 263 million malaria cases and 597,000 malaria deaths in 83 countries. The WHO Africa Region carries a disproportionately high share of the global malaria burden. In 2023, the WHO Africa Region was home to 95% of malaria cases (246 million) and 95% (569,000) of malaria deaths. Children under 5 account for about 76% of all malaria deaths in the Region.

Who is at risk?

Malaria highly affects infants, children under 5 years, pregnant women, girls, travelers, and people with HIV or AIDS, who are at higher risk of severe infection.

Lower the risk

• Use mosquito nets when sleeping in places where malaria is present.
• Use mosquito repellents (containing DEET, IR3535, or Icaridin) after dusk.
• Use coils and vaporizers.
• Wear protective clothing.
• Use window screens.

Prevalence of malaria in The Gambia:

Malaria remains a significant public health concern in The Gambia, with high incidence rates, particularly in the Upper River Region. While efforts to control and prevent malaria have led to a decline in malaria positivity rates in some areas, the disease continues to be a major cause of morbidity and mortality, especially among children and pregnant women.

Key findings from studies on malaria prevalence in The Gambia show that the Upper River Region consistently shows the highest burden of malaria compared to other regions in The Gambia.

2. Diarrhea 

Diarrhea disease is the third leading cause of death in children 1-59 months of age in the world, according to the WHO. It is both preventable and treatable. Each year, diarrhea kills around 443,832 children under 5 and an additional 50,851 children aged 5 to 9 years. A significant proportion of diarrhea disease can be prevented through safe drinking water, adequate sanitation, and hygiene.

Diarrhea is a loose, watery, possibly more frequent passage of stool. Is a common problem sometimes, it’s the only symptom of a condition. At other times, it may be associated with other symptoms, such as nausea, vomiting, abdominal pain, or weight loss.

Who is at risk?

People of all ages can get diarrhea. Children who are malnourished or have impaired immunity, as well as people living with HIV, are most at risk of life-threatening diarrhea.

Some common risk factors for diarrhea include:

• Exposure to viruses, bacteria, or parasites: This is a major risk factor for the sudden onset of diarrhea.
• Diet: Certain foods or drinks, including coffee, tea, dairy products, or foods containing artificial sweeteners, can cause diarrhea in some people.
• Medicines: Some medicines, such as antibiotics, laxatives, magnesium supplements, antidepressants, NSAIDs, chemotherapy, and immunotherapy, can cause diarrhea.

How to prevent diarrhea?

You can’t always prevent diarrhea, but you can reduce your risk of getting it because of infections or food contamination, according to Cleveland Clinic.

• Practice good hygiene: Wash your hands with soap and water after using the bathroom or preparing and eating food. Another option is to use sanitizer.
• Get vaccinated: The rotavirus vaccine prevents rotavirus, a common cause of diarrhea. The vaccine for COVID-19 can reduce your risk of getting COVID and experiencing COVID symptoms, including diarrhea.
• Store food properly: Store food at the correct temperatures, and cook all foods until they reach the recommended temperatures. Don’t take chances by consuming foods or drinks past their expiration dates.
• Watch what you drink when you travel: Don’t drink untreated water when you travel. Avoid tap water, ice cubes, or brushing your teeth with tap water. Steer clear of unpasteurized milk or juice products. Pasteurization is a process that kills germs in certain drinks. When in doubt, drink bottled water or something that’s been boiled first (coffee or tea).
• Watch what you eat when you travel: Avoid raw or undercooked meats (and shellfish), as well as raw fruits and vegetables. Fruits and veggies are usually healthy options, but the skin may contain contaminants that can make you sick.

Prevalence of diarrhea in The Gambia

A study conducted in 2022 in Basse, in the Upper River Region (URR), published on Point Newspaper, revealed a high prevalence of Shigella infections among children aged 6 to 35 months, along with increasing resistance to commonly used antibiotics. These results emphasize an urgent need to revise treatment guidelines, invest in diagnostics, and fast-track vaccine development.

3. Typhoid

As of 2019, an estimated 9 million people get sick from typhoid, and 110,000 people die from it every year. Symptoms include prolonged fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhea. Some patients may have a rash. Severe cases may lead to serious complications or even death. Typhoid fever can be treated with antibiotics, although increasing resistance to different types of antibiotics is making treatment more complicated, according to World Health Organization.

How to prevent typhoid?

The best way to reduce your risk of typhoid fever is to get vaccinated if you live in or are travelling to an area where it’s common. There are oral and injectable (shot) versions. Depending on which type you get, you’ll need to get them one to two weeks before you travel.

Safe food handling practices include:

• Don’t make food for others if you’re sick.
• Wash your hands with soap and water before and after preparing food or eating, and after going to the bathroom.
• Wash surfaces and utensils used for food prep and eating before and after use.
• If you’re unsure whether the food you’re eating is safe, eat mostly well-cooked or packaged food.
• Don’t drink untreated water or eat food prepared with untreated water. If you’re unsure, it’s safest to use bottled water and cook with.

Prevalence of typhoid in The Gambia

The “Burden of Typhoid in The Gambia” an extract from “The Global Burden of Disease 2021” study published by the Institute for Health Metrics and Evaluation, highlighted that The Gambia is a typhoid-endemic country which has experienced at least:

• 2,450 typhoid cases (102 cases per 100,00)
• 44 typhoid deaths
• 3,496 disability adjusted life-years lost to typhoid.

Typhoid is endemic in The Gambia, meaning it is consistently present in the population.

While typhoid is rarely fatal, the recovery is long and difficult. The disease steals time, money, and productivity from those infected and their families and is associated with numerous long-term complications, the Typhoid Vaccine Acceleration and the Coalition Against Typhoid wrote  in a fact-sheet published here.

4. Cholera

Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the bacterium Vibrio cholerae. Cholera remains a global threat to public health and is an indicator of inequity and lack of social development. Researchers have estimated that every year, there are 1.3 to 4 million cases of cholera and 21,000 to 143,000 deaths worldwide due to the infection.

Cholera is an extremely serious disease that can cause severe acute watery diarrhoea with severe dehydration. It takes between 12 hours and 5 days for a person to show symptoms after consuming contaminated food or water. Cholera affects both children and adults and can kill within hours if untreated.

Risk factors?

Outbreaks of cholera are more likely to happen in areas without running water, toileting facilities, or ways to sanitize drinking and cooking water. They can also occur in areas affected by a natural disaster (like an earthquake or flood).

While anyone who ingests V. cholerae can get infected, some people are at higher risk. You might be at increased risk for cholera if you:

• Are female
• Have type O blood
• Have low stomach acid, or hypochlorhydria (for example, if you take antacids or proton pump inhibitors)
• Have had a gastrectomy
• Have an H. pylori infection

Prevention?

Drinking water that’s been sanitized and washing your hands with clean water and soap are the best ways to reduce your risk of cholera. Drink and cook with bottled water if you’re unsure whether the water where you are is safe to consume.

If you live in or are traveling to a place where you’ll be at higher risk for cholera, there are oral vaccines available. They can help reduce your risk of getting sick, but don’t eliminate your risk.

On a larger scale, the best way to prevent cholera is for people to have access to clean drinking water and toilet facilities. This requires global humanitarian and public health efforts.

Prevalence of cholera in The Gambia

Cholera is present in The Gambia, with approximately 65% of the population at risk. While not currently experiencing a widespread outbreak, the disease is considered endemic, meaning it is consistently present in the area. The last reported cholera outbreak in The Gambia was in 2008.

5. Denge Fever

Dengue is a viral infection caused by four types of viruses (DENV-1, DENV-2, DENV-3, DENV-4) belonging to the Flaviviridae family. The viruses are transmitted through the bite of infected Aedes aegypti and Aedes albopictus female mosquitoes that feed both indoors and outdoors during the daytime (from dawn to dusk).

These mosquitoes thrive in areas with standing water, including puddles, water tanks, containers, and old tires. Lack of reliable sanitation and regular garbage collection also contributes to the spread of the mosquitoes.

Who is at risk?

Risk of dengue exists in tropical and subtropical areas of Central America, South America, Africa, Asia, and Oceania. All travellers are at risk during outbreaks. Long-term travellers and humanitarian workers going to areas where Dengue is endemic are at higher risk. Dengue occurs in urban and suburban settings, with higher transmission rates happening during the rainy season.

How to prevent dengue?

The best way to reduce your risk of dengue fever is to protect yourself from mosquito bites. Steps include:

• Use EPA-registered insect repellents that contain 20% to 30% DEET or other ingredients known to help keep Aedes mosquitoes away.
• Cover exposed skin outdoors, especially at night when mosquitoes are more likely to be around.
• Remove standing water (buckets or barrels, bird baths, old tires that may hold rainwater) and fill low spots where water can pool.
• Keep mosquitoes outside of your home by repairing holes in screens and keeping windows and doors closed if possible.
• Use mosquito netting at night in areas where dengue is common.
• If you’re pregnant, avoid traveling to areas where dengue is common if possible.
• When traveling, be sure to check with the CDC to understand if there are any outbreaks of illness in your destination before you leave.

Prevalence of Dengue in The Gambia

Dengue fever is present in Gambia, with sporadic cases and occasional outbreaks reported. While the disease is present throughout the country, it tends to be more prevalent during the rainy season when mosquito populations are high. Specific regional prevalence data within Gambia is not readily available in the provided search results.

Research done by medrxiv shows that the 453 reports screened, 87 from 25 African countries were selected for systematic review. Between 2013 and 2023, approximately 200,000 suspected dengue cases, 90,000 confirmed cases, and 900 deaths were reported in Africa. Over 80% of confirmed cases originated from West Africa, with Burkina Faso reporting over 500 cases per 100,000 population. DENV1 and DENV2 predominating at different times, with transmission closely linked to rainy seasons.