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Malaria Information and Prophylaxis, by Country [M]

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CountryAreas with MalariaEstimated relative risk of Malaria for US Travelers2Drug Resistance3Malaria Species4Recommended Chemoprophlaxis5Helpful links for Select Countries
Macau SAR (China)NoneNoneNot ApplicableNot ApplicableNot Applicable
MacedoniaNoneNoneNot ApplicableNot ApplicableNot Applicable
MadagascarAllModerateChloroquineP. falciparum 85%
P. vivax 5-10%
P. ovale 5%
Atovaquone-proguanil, doxycycline, or mefloquine
Madeira Islands (Portugal)NoneNoneNot ApplicableNot ApplicableNot Applicable
MalawiAllModerateChloroquineP. falciparum 90%
P. malariae, P. ovale, and P. vivax 10% combined
Atovaquone-proguanil, doxycycline, or mefloquine
MalaysiaPresent in rural areas of Malaysian Borneo (Sabah and Sarawak Provinces), and to a lesser extent in rural areas of Peninsular MalaysiaLowChloroquineP. falciparum 40%
P. vivax 50%;
remainder P. malariae, P. knowlesi, and P. ovale.
P. knowlesi reported to cause 28% of cases in Sarawak, and known to cause cases in both Malaysia Borneo and Peninsular Malaysia
Atovaquone-proguanil, doxycycline, or mefloquine
MaldivesNoneNoneNot ApplicableNot ApplicableNot Applicable
MaliAllHighChloroquineP. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
MaltaNoneNoneNot ApplicableNot ApplicableNot Applicable
Marshall IslandsNoneNoneNot ApplicableNot ApplicableNot Applicable
Martinique (France)NoneNoneNot ApplicableNot ApplicableNot Applicable
MauritaniaPresent in southern provinces, including the city of Nouakchott.HighChloroquineP. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
MauritiusNoneNoneNot ApplicableNot ApplicableNot Applicable
Mayotte (France)AllNo dataChloroquineP. falciparum 40-50%
P. vivax 35-40%
P. ovale <1%
Atovaquone-proguanil, doxycycline, or mefloquine
MexicoPresent in Chihuahua, Chiapas, Durango, Nayarit, Oaxaca, and Sinaloa. Rare cases in Jalisco, Quintana Roo, Sonora, and Tabasco. No malaria along the United States-Mexico border.LowNoneP. vivax 100%Areas with malaria except states of Jalisco, Quintana Roo, Sonora, and Tabasco: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7

States of Jalisco, Quintana Roo, Sonora, and Tabasco: Mosquito avoidance only
Micronesia, Federated States of; Includes: Yap Islands, Pohnpei, Chuuk, and KosraeNoneNoneNot ApplicableNot ApplicableNot Applicable
MoldovaNoneNoneNot ApplicableNot ApplicableNot Applicable
MonacoNoneNoneNot ApplicableNot ApplicableNot Applicable
MongoliaNoneNoneNot ApplicableNot ApplicableNot Applicable
MontenegroNoneNoneNot ApplicableNot ApplicableNot Applicable
Montserrat (U.K.)NoneNoneNot ApplicableNot ApplicableNot Applicable
MoroccoNoneNoneNot ApplicableNot ApplicableNot Applicable
MozambiqueAllModerateChloroquineP. 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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