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Malaria Information and Prophylaxis, by Country [B]

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CountryAreas with MalariaEstimated relative risk of Malaria for US Travelers2Drug Resistance3Malaria Species4Recommended Chemoprophlaxis5Helpful links for Select Countries
Bahamas, TheNoneNoneNot ApplicableNot ApplicableNot Applicable
BahrainNoneNoneNot ApplicableNot ApplicableNot Applicable
BangladeshAll areas, except in the city of Dhaka.LowChloroquineMore than half P. falciparum, remainder P. vivax.Atovaquone-proguanil, doxycycline, or mefloquine.
BarbadosNoneNoneNot ApplicableNot ApplicableNot Applicable
BelarusNoneNoneNot ApplicableNot ApplicableNot Applicable
BelgiumNoneNoneNot ApplicableNot ApplicableNot Applicable
BelizeAll areas, especially the districts of Cayo, Stann Creek, and Toledo.  None in Belize City and islands frequented by tourists.LowNoneP. vivax 95%
P. falciparum 5%
Districts of Cayo, Stann Creek, and Toledo: Atovaquone/proguanil, chloroquine, doxycycline, mefloquine, or primaquine7

All other areas with malaria: Mosquito avoidance
BeninAllHighChloroquineP. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Bermuda (U.K.)NoneNoneNot ApplicableNot ApplicableNot Applicable
BhutanRural areas below 1,700 m (5,577 ft) especially the southern belt districts along the border with India: Chirang, Geylegphug, Samchi, Samdrup, Jongkhar, and Shemgang.Very lowChloroquineP. falciparum 60%
P. vivax 40%
Atovaquone-proguanil, doxycycline, or mefloquine
BoliviaAll areas below 2,500 m (8,202 ft). None in the city of La PazLowChloroquineP. vivax 93%
P. falciparum 7%
AAtovaquone-proguanil, doxycycline, mefloquine, or primaquine7
Bosnia and HerzegovinaNoneNoneNot ApplicableNot ApplicableNot Applicable
BotswanaPresent in the following districts: Central and North West (including Chobe National Park) None in the cities of Francistown and Gabarone.Very LowChloroquineP. falciparum 90%
P. vivax 5%
P. ovale 5%
Atovaquone-proguanil, doxycycline, or mefloquine
BrazilStates of Acre, Amapa, Amazonas, Maranhão, Mato Grosso, Para,  Rondonia, Roraima, and Toncantins.  Also present in urban areas, including cities such as Belem, Boa Vista, Macapa, Manaus, Maraba, Porto Velho, and Santarem. Rare cases in Cuiaba City. No transmission at Iguassu Falls.LowChloroquineP. vivax 85% P. falciparum 15%

Areas with malaria except Cuiaba City: Atovaquone-proguanil, doxycycline, or mefloquine.   

Cuiaba City: Mosquito avoidance only.

British Indian Ocean Territory; Includes Diego Garcia (U.K.)NoneNoneNot ApplicableNot ApplicableNot Applicable
BruneiNoneNoneNot ApplicableNot ApplicableNot Applicable
BulgariaNoneNoneNot ApplicableNot ApplicableNot Applicable
Burkina FasoAllHighChloroquineP. falciparum 80%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Burma (Myanmar)Present at altitudes below 1,000 m (3,281 ft). None in the cities of Mandalay and Rangoon (Yangoon).ModerateChloroquine
Mefloquine
P. falciparum 90%, remainder P. malariae, P.ovale, and P. vivaxIn the provinces of Bago, Kachin, Kayah, Kayin, Shan, and Tanintharyi: Atovaquone-proguanil or doxycycline.
All other areas with malaria: Atovaquone-proguanil, doxycycline, or mefloquine.
BurundiAllModerateChloroquineP. falciparum 86%
Remainder P. malariae, P.ovale, and P. vivax
Atovaquone-proguanil, doxycycline, or mefloquine
  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.
  2. This estimate of risk is based on numbers of cases of malaria reported in US travelers and the estimated volume of travel to these countries. In some instances the risk may be low because the actual intensity of transmission is low in that country. In other instances, significant malaria transmission may occur only in small focal areas of the country where US travelers seldom go. Thus even though the risk for the average traveler to that country may be low, the risk for the rare traveler going to the areas with higher transmission intensity will of course be higher. For some countries that are rarely visited by US travelers, there is insufficient information to make a risk estimate.
  3. Refers to P. falciparum malaria unless otherwise noted.
  4. Estimates of malaria species are based on best available data from multiple sources.
  5. 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.
  6. This risk estimate is based largely on cases occurring in US military personnel who travel for extended periods of time with unique itineraries that likely do not reflect the risk for the average US traveler.
  7. Primaquine can cause hemolytic anemia in persons with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Patients must be screened for G6PD deficiency prior to starting primaquine.
 
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