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Malaria Information and Prophylaxis, by Country [B]

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Country Areas with Malaria Estimated relative risk of Malaria for US Travelers2 Drug Resistance3 Malaria Species4 Recommended Chemoprophlaxis5 Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries
Bahamas, The None None Not Applicable Not Applicable Not Applicable
Bahrain None None Not Applicable Not Applicable Not Applicable
Bangladesh All areas, except in the city of Dhaka. Low Chloroquine P.falciparum 90%, P. vivax 10%, and P. malariae rare Atovaquone-proguanil, doxycycline, or mefloquine.
Barbados None None Not Applicable Not Applicable Not Applicable
Belarus None None Not Applicable Not Applicable Not Applicable
Belgium None None Not Applicable Not Applicable Not Applicable
Belize Rare locally transmitted cases. None in Belize City and islands frequented by tourists such as Ambergris Caye. Very low None P.vivax 100% Mosquito avoidance only.
Benin All High Chloroquine P. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Bermuda (U.K.) None None Not Applicable Not Applicable Not Applicable
Bhutan Rare cases in rural areas <1,700 m (5,577 ft) in districts along the southern border shared with India. Also rare seasonal cases May-Sept in  in Ha, Lhuentse, Monggar, Punakha, Trashigang, Trongsa, Tsirang, Yangtse, and Wangdue.  None in districts of Bumthang, Gaza, Haa, Paro, and Thimphu. Very low Chloroquine P. falciparum 70%
P. vivax 30%

Mosquito avoidance only.

 

Bolivia All areas below 2,500 m (8,202 ft). None in the city of La Paz Low Chloroquine P. vivax 93%
P. falciparum 7%
Atovaquone-proguanil, doxycycline, mefloquine, or primaquine7
Bosnia and Herzegovina None None Not Applicable Not Applicable Not Applicable
Botswana Present in the following districts: Central and North West (including Chobe National Park). None in the cities of Francistown and Gabarone. Low Chloroquine P. falciparum 90%
P. vivax 5%
P. ovale 5%
Atovaquone-proguanil, doxycycline, or mefloquine

1) City(ies) of travel
2) District(s) of travel

Map of districts in Botswana

To determine if a city is within a certain district

Brazil All areas of the states of Acre, Amapa, Amazonas, Rondonia, and Roraima. Also present in the states of Maranhão, Mato Grosso, and Para, but rare cases in their capital cities. Rare cases in the rural areas of the states of Espirito Santo, Goias, Mato Grasso do Sul, Piaui, and Tocantins. Rare cases in the rural forested areas of the states of Rio de Janeiro and Sao Paolo. No malaria in the cities of Brasilia, Rio de Janeiro, São Paolo, and none at Iguaçu Falls Low Chloroquine P. vivax 85% P. falciparum 15%

States of Acre, Amapa, Amazonas, Rondonia, and Roraima. States of Maranhão, Mato Grosso, and Para (but not their capital cities): Atovaquone-proguanil, doxycycline, or mefloquine 

Areas with rare cases: 

Mosquito avoidance only.

British Indian Ocean Territory; Includes Diego Garcia (U.K.) None None Not Applicable Not Applicable Not Applicable
Brunei None None Not Applicable Not Applicable Not Applicable
Bulgaria None None Not Applicable Not Applicable Not Applicable
Burkina Faso All High Chloroquine P. 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), including Bagan. Rare transmission above 1,000m (3,281 ft). Moderate Chloroquine
Mefloquine
P. falciparum 60%,
P. vivax 35%, P. malariae, P. ovale, and P. knowlesi rare

In the provinces of Bago, Kachin, Kayah, Kayin, Shan, and Tanintharyi below 1,000m (3,281 ft): Atovaquone-proguanil or doxycycline.
All other areas with malaria: Atovaquone-proguanil, doxycycline, or mefloquine.

Above 1,000m (3,281 ft):
Mosquito avoidance only.

Burundi All Moderate Chloroquine P. falciparum 86%
P. malariae, P.ovale, and P. vivax 14% combined.
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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