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Malaria Information and Prophylaxis, by Country [S]

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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
Saint Helena (U.K.) None None Not Applicable Not Applicable Not Applicable
Saint Kitts (Saint Christopher) and Nevis (U.K.) None None Not Applicable Not Applicable Not Applicable
Saint Lucia None None Not Applicable Not Applicable Not Applicable
Saint Pierre and Miquelon (France) None None Not Applicable Not Applicable Not Applicable
Saint Vincent and the Grenadines None None Not Applicable Not Applicable Not Applicable
Samoa (formerly Western Samoa) None None Not Applicable Not Applicable Not Applicable
San Marino None None Not Applicable Not Applicable Not Applicable
São Tomé and Príncipe All Very Low Chloroquine P. falciparum 85%
Remainder P. malariae, P. ovale, and P. vivax
Atovaquone-proguanil, doxycycline, or mefloquine
Saudi Arabia Present in emirates by border with Yemen, specifically Asir and Jizan. None in cities of Jeddah, Mecca, Medina, Riyadh, and Ta’if. Very Low Chloroquine P. falciparum predominantly
Remainder P. vivax
Atovaquone-proguanil, doxycycline, or mefloquine
Senegal All High Chloroquine P. falciparum >85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Serbia None None Not Applicable Not Applicable Not Applicable
Seychelles None None Not Applicable Not Applicable Not Applicable
Sierra Leone All High Chloroquine P. falciparum 85%
P. ovale potentially 5%-10%,
P. malariae and P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
Singapore None None Not Applicable Not Applicable Not Applicable
Slovakia None None Not Applicable Not Applicable Not Applicable
Slovenia None None Not Applicable Not Applicable Not Applicable
Solomon Islands All High Chloroquine P. falciparum 60%
P. vivax 35-40%
P. ovale <1%
Atovaquone-proguanil, doxycycline, or mefloquine
Somalia All High Chloroquine P. falciparum 90%
P. vivax 5%-10%
P. malariae, and P. ovale rare
Atovaquone-proguanil, doxycycline, or mefloquine
South Africa Present in northeastern KwaZulu-Natal Province as far south as the Tugela River, Limpopo (Northern) Province, and the Mpumalanga Province. Present in Kruger National Park. Low Chloroquine P. falciparum 90%
P. vivax 5%
P. ovale 5%
Atovaquone-proguanil, doxycycline, or mefloquine
South Georgia and the South Sandwich Islands None None Not Applicable Not Applicable Not Applicable
South Korea Limited to the months of March–December in rural areas in the northern parts of Incheon, Kangwon-do, Kyonggi-do Provinces including the demilitarized zone (DMZ). Low None P. vivax 100%

Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7

 

South Sudan, Republic of All High Chloroquine P. falciparum 90%,
P.vivax 5%–10%,
P. malariae and P. ovale rare.
Atovaquone-proguanil, doxycycline, or mefloquine
Spain None None Not Applicable Not Applicable Not Applicable
Sri Lanka Last locally transmitted case in October 2012 None Not applicable Not applicable Not applicable
Sudan All High Chloroquine P. falciparum 90%,
P.vivax 5%–10%,
P. malariae and P. ovale rare.
Atovaquone-proguanil, doxycycline, or mefloquine
Suriname Present in provinces of Brokopondo and Sipaliwini. Rare cases in Paramaribo. Moderate Chloroquine P. falciparum 70%
P. vivax 15-20%
Brokopondo and Sipaliwini: Atovaquone-proguanil, doxycycline,
or
mefloquine.

Paramaribo:
Mosquito avoidance only.
Swaziland Present in eastern areas bordering Mozambique and South Africa, including all of Lubombo district and the eastern half of Hhohho, Manzini, and Shiselweni districts. Very Low Chloroquine P. falciparum 99%
P. ovale and P. vivax 1%
Atovaquone-proguanil, doxycycline, or mefloquine
Sweden None None Not Applicable Not Applicable Not Applicable
Switzerland None None Not Applicable Not Applicable Not Applicable
Syria 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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