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Malaria Information and Prophylaxis, by Country [S]

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CountryAreas with MalariaEstimated relative risk of Malaria for US Travelers2Drug Resistance3Malaria Species4Recommended Chemoprophlaxis5Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries
Saint Helena (U.K.)NoneNoneNot ApplicableNot ApplicableNot Applicable
Saint Kitts (Saint Christopher) and Nevis (U.K.)NoneNoneNot ApplicableNot ApplicableNot Applicable
Saint LuciaNoneNoneNot ApplicableNot ApplicableNot Applicable
Saint Pierre and Miquelon (France)NoneNoneNot ApplicableNot ApplicableNot Applicable
Saint Vincent and the GrenadinesNoneNoneNot ApplicableNot ApplicableNot Applicable
Samoa (formerly Western Samoa)NoneNoneNot ApplicableNot ApplicableNot Applicable
San MarinoNoneNoneNot ApplicableNot ApplicableNot Applicable
São Tomé and PríncipeAllVery LowChloroquineP. falciparum 85%
Remainder P. malariae, P. ovale, and P. vivax
Atovaquone-proguanil, doxycycline, or mefloquine
Saudi ArabiaPresent in emirates by border with Yemen, specifically Asir and Jizan. None in cities of Jeddah, Mecca, Medina, Riyadh, and Ta’if.Very LowChloroquineP. falciparum predominantly
Remainder P. vivax
Atovaquone-proguanil, doxycycline, or mefloquine
SenegalAllHighChloroquineP. falciparum >85%
P. ovale 5-10%
P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
SerbiaNoneNoneNot ApplicableNot ApplicableNot Applicable
SeychellesNoneNoneNot ApplicableNot ApplicableNot Applicable
Sierra LeoneAllHighChloroquineP. falciparum 85%
P. ovale potentially 5%-10%,
P. malariae and P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
SingaporeNoneNoneNot ApplicableNot ApplicableNot Applicable
SlovakiaNoneNoneNot ApplicableNot ApplicableNot Applicable
SloveniaNoneNoneNot ApplicableNot ApplicableNot Applicable
Solomon IslandsAllHighChloroquineP. falciparum 60%
P. vivax 35-40%
P. ovale <1%
Atovaquone-proguanil, doxycycline, or mefloquine
SomaliaAllHighChloroquineP. falciparum 90%
P. vivax 5%-10%
P. malariae, and P. ovale rare
Atovaquone-proguanil, doxycycline, or mefloquine
South AfricaPresent in northeastern KwaZulu-Natal Province as far south as the Tugela River, Limpopo (Northern) Province, and the Mpumalanga Province. Present in Kruger National Park.LowChloroquineP. falciparum 90%
P. vivax 5%
P. ovale 5%
Atovaquone-proguanil, doxycycline, or mefloquine
South Georgia and the South Sandwich IslandsNoneNoneNot ApplicableNot ApplicableNot Applicable
South KoreaLimited 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).LowNoneP. vivax 100%

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


South Sudan, Republic ofAllHighChloroquineP. falciparum 90%,
P.vivax 5%–10%,
P. malariae and P. ovale rare.
Atovaquone-proguanil, doxycycline, or mefloquine
SpainNoneNoneNot ApplicableNot ApplicableNot Applicable
Sri LankaLast locally transmitted case in October 2012NoneNot applicableNot applicableNot applicable
SudanAllHighChloroquineP. falciparum 90%,
P.vivax 5%–10%,
P. malariae and P. ovale rare.
Atovaquone-proguanil, doxycycline, or mefloquine
SurinamePresent in provinces of Brokopondo and Sipaliwini. Rare cases in Paramaribo.ModerateChloroquineP. falciparum 70%
P. vivax 15-20%
Brokopondo and Sipaliwini: Atovaquone-proguanil, doxycycline,

Mosquito avoidance only.
SwazilandPresent in eastern areas bordering Mozambique and South Africa, including all of Lubombo district and the eastern half of Hhohho, Manzini, and Shiselweni districts.Very LowChloroquineP. falciparum 99%
P. ovale and P. vivax 1%
Atovaquone-proguanil, doxycycline, or mefloquine
SwedenNoneNoneNot ApplicableNot ApplicableNot Applicable
SwitzerlandNoneNoneNot ApplicableNot ApplicableNot Applicable
SyriaNoneNoneNot 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. The U.S. Government's Official Web PortalDepartment of Health and Human Services
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