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Malaria Information and Prophylaxis, by Country [C]

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Country Areas with Malaria Estimated relative risk of Malaria for US Travelers 2 Drug Resistance3 Malaria Species4 Recommended Chemoprophlaxis5 Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries
Cambodia Present throughout the country including Siem Reap city. None in the city of Phnom Penh and the temple complex at Angkor Wat. Low Chloroquine
Mefloquine
P. falciparum 86%
P. vivax 12%
P. malariae 2%,
P. knowlesi rare
In the provinces of Banteay Meanchey, Battambang, Kampot, Koh Kong, Odder Meanchey, Pailin, Preah Vihear, Pursat, and Siem Reap bordering Thailand: Atovaquone-proguanil or doxycycline
All other areas with malaria: Atovaquone-proguanil, doxycycline, or mefloquine
Cameroon All High Chloroquine P. falciparum >85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Canada None None Not Applicable Not Applicable Not Applicable
Canary Islands (Spain) None None Not Applicable Not Applicable Not Applicable
Cape Verde Limited cases in Sao Tiago Island. Very Low Chloroquine PrimarilyP. falciparum Mosquito avoidance only
Cayman Islands (U.K.) None None Not Applicable Not Applicable Not Applicable
Central African Republic All High Chloroquine P. falciparum 85%
P. malariae, P. ovale, and P. vivax 15% combined
Atovaquone-proguanil, doxycycline, or mefloquine
Chad All High Chloroquine P. falciparum 85%
P. malariae, P. ovale, and P. vivax 15% combined
Atovaquone-proguanil, doxycycline, or mefloquine
Chile None None Not Applicable Not Applicable Not Applicable
China Present in the counties along the China-Burma (Myanmar) border in Yunnan Province. Limited transmission in Motuo county in Tibet. No malaria in areas where  most major river cruises pass. Very Low Chloroquine
Mefloquine
Primarily P. vivax
P. falciparum in Yunnan Province only.
Along China-Burma (Myanmar) border in the western part of Yunnan province: Atovaquone-proguanil or doxycycline. Motuo county in Tibet: Mosquito avoidance only.
Christmas Island (Australia) None None Not Applicable Not Applicable Not Applicable
Cocos (Keeling) Islands (Australia) None None Not Applicable Not Applicable Not Applicable
Colombia All areas at altitudes below 1,700 m (5,577 ft). None in Bogota, Cartagena, and Medellin. Low Chloroquine P. falciparum 50%
P. vivax 50%
Atovaquone-proguanil, doxycycline, or mefloquine
Comoros All No data Chloroquine Primarily P. falciparum Atovaquone-proguanil, doxycycline, or mefloquine
Congo, Republic of the (Congo-Brazzaville) All High Chloroquine P. falciparum 90%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Cook Islands (New Zealand) None None Not Applicable Not Applicable Not Applicable
Costa Rica None None Not applicable Not applicable Not applicable
Côte d'Ivoire All High Chloroquine P. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Croatia None None Not Applicable Not Applicable Not Applicable
Cuba None None Not Applicable Not Applicable Not Applicable
Cyprus None None Not Applicable Not Applicable Not Applicable
Czech Republic None None Not Applicable Not Applicable Not Applicable
  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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