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Malaria Information and Prophylaxis, by Country [M]

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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
Macau SAR (China) None None Not Applicable Not Applicable Not Applicable
Macedonia None None Not Applicable Not Applicable Not Applicable
Madagascar All areas, except rare cases in Antananarivo. Moderate Chloroquine P. falciparum 85%
P. vivax 5-10%
P. ovale 5%

All areas except Antananarivo: Atovaquone-proguanil, doxycycline, or mefloquine

Antananarivo: Mosquito avoidance only.

Madeira Islands (Portugal) None None Not Applicable Not Applicable Not Applicable
Malawi All Moderate Chloroquine P. falciparum 90%
P. malariae, P. ovale, and P. vivax 10% combined
Atovaquone-proguanil, doxycycline, or mefloquine
Malaysia Present in rural areas. Low Chloroquine P. falciparum
P. vivax
P. malariae,
P. knowlesi,
and P. ovale.
Atovaquone-proguanil, doxycycline, or mefloquine
Maldives None None Not Applicable Not Applicable Not Applicable
Mali All High Chloroquine P. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Malta None None Not Applicable Not Applicable Not Applicable
Marshall Islands None None Not Applicable Not Applicable Not Applicable
Martinique (France) None None Not Applicable Not Applicable Not Applicable
Mauritania All areas including the city of Nouakchott. High Chloroquine P. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Mauritius None None Not Applicable Not Applicable Not Applicable
Mayotte (France) All No data Chloroquine P. falciparum 40-50%
P. vivax 35-40%
P. ovale <1%
Atovaquone-proguanil, doxycycline, or mefloquine
Mexico

Present in Chiapas, Chihuahua, Durango, Nayarit, and Sinaloa.  Rare cases in Campeche, Jalisco, Oaxaca, Sonora, and Tabasco. Rare cases in the municipality of Othon P. Blanco in the southern part of Quintana Roo bordering Belize. No malaria along the United States-Mexico border.

Very Low None P. vivax 100%

States of Chiapas, Chihuahua, Durango, Nayarit, and Sinaloa: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7

States of Campeche, Jalisco, Oaxaca, Sonora, Tabasco, and Othon P. Blanco municipality of Quintana Roo: Mosquito avoidance only

 

Micronesia, Federated States of; Includes: Yap Islands, Pohnpei, Chuuk, and Kosrae None None Not Applicable Not Applicable Not Applicable
Moldova None None Not Applicable Not Applicable Not Applicable
Monaco None None Not Applicable Not Applicable Not Applicable
Mongolia None None Not Applicable Not Applicable Not Applicable
Montenegro None None Not Applicable Not Applicable Not Applicable
Montserrat (U.K.) None None Not Applicable Not Applicable Not Applicable
Morocco None None Not Applicable Not Applicable Not Applicable
Mozambique All Moderate Chloroquine P. falciparum 90%
P. malariae, P. ovale, and P. vivax 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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