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LIVESAY EXPEDITIONS & ADVENTURES
Malaria Risk Information and Prophylaxis, by Country
Kathrine R. Tan, Sonja Mali, Paul M. Arguin
Table 2-24. Malaria risk information and prophylaxis, by country1
Display only: AfghanistanAlbaniaAlgeriaAndorraAngolaAnguilla (U.K.)AntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanAzores (Portugal)The BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermuda (U.K.)BhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBritish Indian Ocean Territory (U.K.)BruneiBulgariaBurkina FasoBurma (Myanmar)BurundiCambodiaCameroonCanadaCanary Islands (Spain)Cape VerdeCayman Islands (U.K.)Central African RepublicChadChileChinaChristmas Island (Australia)Cocos (Keeling) Islands (Australia)ColombiaComorosRepublic of the Congo Cook Islands (New Zealand)Costa RicaCôte d'Ivoire (Ivory Coast)CroatiaCubaCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEaster Island (Chile)Ecuador, including the Galápagos IslandsEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (U.K.)Faroe Islands (Denmark)FijiFinlandFranceFrench Guiana (France)French Polynesia, including the island groups of Society Islands (Tahiti, Moorea, and Bora-Bora), Marquesas Islands (Hiva Oa and Ua Huka), and Austral Islands (Tubuai and Rurutu)GabonThe GambiaGeorgiaGermanyGhanaGibraltar (U.K.)GreeceGreenland (Denmark)GrenadaGuadeloupe, including St. Barthelemy and Saint Martin (France)Guam (U.S.)GuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong Kong SAR (China)HungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItaly, including Holy See and Vatican CityJamaicaJapanJordanKazakhstanKenyaKiribati (formerly Gilbert Islands), includes Tarawa, Tabuaeran (Fanning Island), and Banaba (Ocean Island)North KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacau SAR (China)MacedoniaMadagascarMadeira Islands (Portugal)MalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartinique (France)MauritaniaMauritiusMayotte (France)MexicoThe Federated States of Micronesia (Including Yap Islands, Pohnpei, Chuuk, and Kosrae)MoldovaMonacoMongoliaMontenegroMontserrat (U.K.)MoroccoMozambiqueNamibiaNauruNepalThe NetherlandsNetherlands Antilles, including Bonaire, Curaçao, Saba, St. Eustasius, and St. MaartenNew Caledonia (France)New ZealandNicaraguaNigerNigeriaNiue (New Zealand)Norfolk Island (Australia)Northern Mariana Islands (U.S.), including Saipan, Tinian, and Rota IslandNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn Islands (U.K.)PolandPortugalPuerto Rico (U.S.)QatarRéunion (France)RomaniaRussiaRwandaSaint Helena (U.K.)Saint Kitts and NevisSaint LuciaSaint Pierre and Miquelon (France)Saint Vincent and the GrenadinesSamoaAmerican SamoaSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich Islands (U.K.)SpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzania, including ZanzibarThailandTimor-Leste (East Timor)TogoTokelau (New Zealand)TongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos Islands (U.K.)TuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom, including England, Scotland, Wales, and Northern IrelandUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamBritish Virgin IslandsU.S. Virgin IslandsWestern Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Afghanistan
P. falciparum Atovaquone/proguanil, Anguilla (U.K.)
Antarctica
Antigua and
Rural areas of Salta and Jujuy province (along Argentina
province (along border of Paraguay). Malaria present in Iguassu FallsPreviously limited to the Ararat Valley in the Ararat and Artashat Australia
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Azerbaijan
Azores (Portugal)
Bahamas, The
P. falciparum Atovaquone/proguanil, Bangladesh
Barbados
Bermuda (U.K.)
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Rural areas <1,700 m (<5,577 ft) of the southern belt districts Geylegphug, Samchi, Samdrup Jongkhar, Sarpang, and ShemgangAll areas <2,500 m (<8,202 ft) in the following departments: P. vivax 70%– Atovaquone/proguanil, Bosnia and
Herzegovina
North of 22°S in the northern provinces of Central, Chobe, Ghanzi, P. falciparum Atovaquone/proguanil, Botswana
and Tocantins. Parts of states of Maranhaõ (western part), Mato Grosso (northern part), and Pará (except Belem Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
British Indian
Ocean Territory; None
includes Diego
Garcia (U.K.)
Bulgaria
Burkina Faso
In the provinces of Bago, KIayah, Kachin, Kayin, (Myanmar)
Atovaquone/ proguanil, doxycycline, or mefloquine P. malariae, P. doxycycline, or ovale and P. In the provinces of Preah Vihear, Siemreap, Oddar Meanchey, Banteay Meanchey, Battambang, Chloroquine P. falciparum Kong, and Pursat Cambodia
All other areas: Atovaquone/proguanil, doxycycline, or mefloquine.
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Cameroon
Canary Islands
Chloroquine P. falciparum doxycycline, or Cape Verde
Cayman Islands None
Central African
Chloroquine P. malariae, P. doxycycline, or Republic
Chloroquine P. malariae, P. doxycycline, or Chloroquine P. falciparum Along China-Burma Atovaquone/ proguanil, doxycycline or mefloquine Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Atovaquone/proguanil, chloroquine, doxycycline or mefloquine All areas with malaria transmission: Mosquito avoidance Christmas Island
(Australia)
Cocos (Keeling)
P. falciparum Atovaquone/proguanil, Colombia
Congo, Republic
of the (Congo-
Brazzaville)
Cook Islands
(New Zealand)
Costa Rica
All other areas with malaria transmission: Mosquito avoidance Côte d'Ivoire
(Ivory Coast)
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Czech Republic
Democratic
P. falciparum Atovaquone/proguanil, Republic of the
Congo (Congo-
Kinshasa)
P. falciparum Atovaquone/ proguanil, Djibouti
Dominica
All areas (including resort areas), except not Dominican
Republic
Easter Island
All areas at altitudes <1,500 m (<4,921 ft). Not present in the cities Ecuador,
including the
Galápagos Islands
El Salvador
Equatorial
Chloroquine P. malariae, P. doxycycline, or Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Chloroquine P. vivax 10%– doxycycline, or Ethiopia
P. malariae and P. ovale <5% Falkland Islands
Faroe Islands
(Denmark)
P. falciparum Atovaquone/proguanil, French Guiana
French Polynesia,
includes the island
groups of Society
Islands (Tahiti,
Moorea, and
Bora-Bora);
Marquesas
Islands (Hiva Oa
and Ua Huka);
and Austral
Islands (Tubuai
and Rurutu)
Chloroquine P. malariae, P. doxycycline, or Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Gambia, The
Chloroquine P. malariae, P. doxycycline, or Gibraltar (U.K.)
Greenland
(Denmark)
Guadeloupe,
including St.
Barthelemy and None
Saint Martin
(France)
Guam (U.S.)
Guatemala
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Guinea-Bissau
P. vivax rareP. falciparum 60% Present throughout the country at altitudes Honduras
Hong Kong SAR
All areas throughout
country except no
Indonesia
Present in rural Sumatra, Chloroquine P. falciparum Atovaquone/proguanil, Sulawesi, Kalimantan Tenggara Barat (includes island of Lombok) All areas of eastern Indonesia (provinces of Papua Indonesia, Irian Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Jaya Barat, Nusa Tenggara Timur, Maluku, and Maluku Utara).
None in Jakarta, resort areas of Bali and the island of Java, except for the Menoreh Hills in central Java. None in urban areas in Sumatra, Kalimantan, Nusa Tenggara Barat and SulawesiRural areas of Sistan-Baluchestan, the southern tropical part of Kerman, and Hormozgan province P. falciparum Atovaquone/proguanil, Azerbijan provinces north of the Zagros mountains during March through NovemberPresent in areas at altitudes <1,500 m (<4,921 ft) in provinces Italy (includes
Holy See)
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Kazakhstan
Kiribati (formerly
Gilbert Islands),
includes Tarawa,
Tabuaeran
(Fanning Island),
and Banaba
(Ocean Island)
Presumed to be chloroquine, doxycycline, Korea, North
Limited to rural areas in the northern parts of Korea, South
Frequent border crossings between neighboring countries with malaria poses a small risk of malaria Kyrgyzstan
along the borders of Tajikistan and Uzbekistan. No malaria transmission reported in Bishkek Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Along the Laos-Burma border in the provinces of Bokèo and Louang Namtha and along the Laos-Thailand border in All other areas: Atovaquone/ proguanil, doxycycline, or mefloquine Liechtenstein
Lithuania
Luxembourg
Macau SAR
Macedonia
Madagascar
Madeira Islands
(Portugal)
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Chloroquine P. malariae, P. doxycycline, or Malaysia
to a lesser extent in rural Chloroquine P. knowlesi Maldives
Marshall Islands None
Martinique
(France)
Mauritania
Mauritius
Mayotte (French
territorial
Chloroquine P. vivax 35%- doxycycline, or collectivity)
P. falciparum chloroquine, doxycycline, Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
borders in the state of Quintana Roo and small foci along the Guatemala border in the states of Chiapas and Tabasco; rural areas in the states of Nayarit, Oaxaca, and Sinaloa; and in an area between 24°N and 28°N latitude, and 106°W and 110°W longitude, which lies in parts of Sonora, Chihuahua, and Durango. No malaria along the United States-Mexico border and in the major resorts along the Pacific and Gulf coasts Micronesia,
Federated States
of; includes Yap
Islands, Pohnpei,
Chuuk, and
Kosrae
Mongolia
Montenegro
Montserrat (U.K.) None
Mozambique
Chloroquine P. malariae, P. doxycycline, or Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Chloroquine P. malariae, P. doxycycline, or Chloroquine P. falciparum doxycycline, or Netherlands
Netherlands
Antilles (Bonaire,
Curaçao, Saba,
St. Eustasius, and
St. Maarten)
New Caledonia
(France)
New Zealand
Nicaragua
P. vivax rareP. falciparum 85% Niue (New
Zealand)
Norfolk Island
(Australia)
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Northern
Mariana Islands
(U.S.), includes
Saipan, Tinian,
and Rota Island
P. falciparum Atovaquone/proguanil, Pakistan
Veragaus, San Blas and Chloroquine P. falciparum Atovaquone/ proguanil, doxycycline, mefloquine, or primaquine5 Papua New
and P. vivax) P. malariae and Paraguay
All departments <2000 Chloroquine P. vivax 70% P. falciparum of Lima, or the highland tourist areas (Cuzco, Machu Picchu, and Lake Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Philippines
Pitcairn Islands
Portugal
Puerto Rico (U.S.) None
Réunion (France) None
P. vivax 100% Azerbaijan: Mosquito P. falciparum Atovaquone/proguanil, Saint Helena
Saint Kitts (Saint
Christopher) and None
Nevis (U.K.)
Saint Lucia
Saint Pierre and
Miquelon
(France)
Saint Vincent and
the Grenadines
Samoa (formerly
Western Somoa)
Samoa, American
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
San Marino
São Tomé and
Chloroquine P. malariae, P. doxycycline, or Príncipe
Provinces of Al Madinah, Asir (excluding the high- P. falciparum Atovaquone/proguanil, Saudi Arabia
Chloroquine predominantly doxycycline, or in cities of Jeddah, Mecca, Medina, Riyadh, and Ta’if Seychelles
Sierra Leone
Chloroquine P. malariae, P. doxycycline, or Singapore
Slovakia
Slovenia
Solomon Islands All
Chloroquine P. vivax 35%- doxycycline, or Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
malariae, and mefloquineP. ovale 5% Present in the Mpumalanga Province, Limpopo (Northern) P. falciparum Atovaquone/proguanil, South Africa
Tugela River. Present in Kruger National Park South Georgia
and the South
Sandwich Islands
All areas, except none in the districts of Colombo, Sri Lanka
Chloroquine P. falciparum doxycycline, or Chloroquine P. malariae, P. doxycycline, or ovale 10%P. falciparum Atovaquone/proguanil, Suriname
Present in the northern and eastern areas P. falciparum Atovaquone/proguanil, Swaziland
Switzerland
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Tajikistan
Chloroquine P. falciparum doxycycline, mefloquine, Tanzania
P. ovale >10% mefloquineP. vivax rare Rural, forested areas that border Cambodia, Laos, and Myanmar (Burma). Phang Nga and Phuket. Chloroquine 75% some Thailand
Timor-Leste (East
P. malariae <1%P. falciparum 85% Tokelau (New
Zealand)
Trinidad and
Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Present by border with Syria. None on the P. falciparum chloroquine, doxycycline, Turkmenistan
P. vivax 100% Mosquito avoidance only Turks and Caicos
Islands (U.K.)
Chloroquine P. malariae, P. doxycycline, or United Arab
Emirates
United Kingdom
(with Channel
Islands and Isle of
United States
Uzbekistan
P. vivax 100% Mosquito avoidance only Chloroquine P. vivax 35%– doxycycline, or Rural areas of the following states: Apure, Venezuela
Present in Angel Falls. None in Margarita Island Recommended
Areas with Malaria
resistance2
Species3
Chemoprophylaxis4
Southern part of the country in the provinces except none in the Red
Atovaquone/ proguanil, doxycycline, or mefloquine Virgin Islands,
Virgin Islands,
Western Sahara
Chloroquine P. malariae, P. doxycycline, or vivax 5%P. falciparum >90% P. ovale up to 5%P. falciparum >90% Zimbabwe
1 The information presented herein was accurate at the time of publication; however, factors that can change rapidly and from year to year, such as local weather conditions, mosquito vector density, and prevalence of infection, can markedly affect local malaria transmission patterns. Updated information may be found on the CDC Travelers’ Health website at2 Refers to P. falciparum malaria.
3 Estimates of malaria species are based on best available data from multiple sources.
4 Several medications are available for chemoprophylaxis. When deciding which drug to use, consider specific itinerary, length of trip, cost of drug, previous adverse reactions to antimalarials, drug allergies, and current medical history. All travelers should seek medical attention in the event of fever during or after return from travel to areas with malaria.
5 Primaquine can cause hemolytic anemia in persons with G6PD deficiency. Patients must be tested and documented to have a normal level of G6PD activity prior to starting primaquine.

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