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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 More than half P. falciparum, remainder P. vivax. 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 Small foci of transmission primarily in select areas of Stann Creek, and Toledo.  Rare locally-transmitted cases in other districts. None in Belize City and islands frequented by tourists such as Ambergris Caye. Very low None P. vivax 95%
P. falciparum 5%
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 Rural areas below 1,700 m (5,577 ft) in districts of Chhukha, Dagana, Pemagatshel, Samdrug Jongkhar, Samtse, Sarpang, and Zhemgang. Rare seasonal cases May-Sept in Ha, Lhuentse, Monggar, Punakha, Trashigang, Trongsa, Tsirang, Yangtse, and Wangdue.  None in districts of Bumthang, Gaza, Paro, and Thimphu. Very low Chloroquine P. falciparum 50%
P. vivax 50%

Districts of Chhukha, Dagana, Pemagatshel, Samdrug Jongkhar, Samtse, Sarpang, and Zhemgang: Atovaquone-proguanil, doxycycline, or mefloquine.

Districts of Ha, Lhuentse, Monggar, Punakha, Trashigang, Trongsa, Tsirang, Yangtse, and Wangdue: 
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. Very Low Chloroquine P. falciparum 90%
P. vivax 5%
P. ovale 5%
Atovaquone-proguanil, doxycycline, or mefloquine
Brazil States 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. Low Chloroquine P. 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.) 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%, remainder P. malariae, P. ovale, and P. knowlesi

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%
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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