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Malaria Information and Prophylaxis, by Country [E]

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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
Easter Island (Chile) None None Not Applicable Not Applicable Not Applicable
Ecuador; Including the Galápagos Islands All areas at altitudes below 1,500 m (4,921 ft).  Not present in the cities of Guayaquil and Quito, or the Galápagos Islands. Low Chloroquine P. vivax 90%
P. falciparum 10%

Guayas, Esmeraldas, and Canar provinces: Atovaquone-proguanil, doxycycline, or mefloquine

All other areas with malaria: Atovaquone-proguanil, doxycycline, mefloquine, or primaquine 7

Egypt None None Not applicable Not applicable Not applicable
El Salvador Rare cases along the Guatemalan border. Very Low None P. vivax 99%
P. falciparum <1%
Mosquito avoidance only
Equatorial Guinea All High Chloroquine P. falciparum 85%
P. malariae, P. ovale, and P. vivax 15% combined
Atovaquone-proguanil, doxycycline, or mefloquine
Eritrea All areas at altitudes below 2,200 m (7,218 ft). None in Asmara. Moderate Chloroquine P. falciparum 85%
P. vivax 10-15% P. ovale rare
Atovaquone-proguanil, doxycycline, or mefloquine
Estonia None None Not Applicable Not Applicable Not Applicable
Ethiopia All areas at altitudes below 2,500 m (8,202 ft) except none in the highly urbanized, central part of the city of Addis Ababa. Moderate Chloroquine P. falciparum 60-70%
P. vivax 30-40%
P. malariae, P. ovale rare
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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