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Malaria Information and Prophylaxis, by Country [N]

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CountryAreas with MalariaEstimated relative risk of Malaria for US Travelers2Drug Resistance3Malaria Species4Recommended Chemoprophlaxis5Helpful links for Select Countries
NamibiaPresent in the provinces of Kunene, Ohangwena, Okavango (Kavango), Omaheke, Omusati, Oshana, Oshikoto, and Otjozondjupa, and in the Caprivi StripLowChloroquineP. falciparum 90%
P. malariae, P. ovale, and P. vivax 10% combined
Atovaquone-proguanil, doxycycline, or mefloquine
NauruNoneNoneNot ApplicableNot ApplicableNot Applicable
NepalPresent throughout country at altitudes below 2,000 m (6,562 ft). None in Kathmandu and on typical Himalayan treks.No dataChloroquineP. vivax 85%
P. falciparum 15%
Atovaquone-proguanil, doxycycline, or mefloquine
NetherlandsNoneNoneNot ApplicableNot ApplicableNot Applicable
Netherlands Antilles (Bonaire, Curaçao, Saba, St. Eustasius, and St. Martin)NoneNoneNot ApplicableNot ApplicableNot Applicable
New Caledonia (France)NoneNoneNot ApplicableNot ApplicableNot Applicable
New ZealandNoneNoneNot ApplicableNot ApplicableNot Applicable
NicaraguaPresent in districts of Chinandega, Leon, Managua, Matagalpa, Región Autónoma Atlántico Norte (RAAN), and Región Autónoma Atlántico Sur (RAAS).LowNoneP. vivax 90%
P. falciparum 10%
Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7
NigerAllHighChloroquineP. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
NigeriaAllHighChloroquineP. falciparum 85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Niue (New Zealand)NoneNoneNot ApplicableNot ApplicableNot Applicable
Norfolk Island (Australia)NoneNoneNot ApplicableNot ApplicableNot Applicable
Northern Mariana Islands (US) Includes Saipan, Tinian, and Rota IslandNoneNoneNot ApplicableNot ApplicableNot Applicable
NorwayNoneNoneNot ApplicableNot ApplicableNot 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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