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Malaria Information and Prophylaxis, by Country [T]

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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
TaiwanNoneNoneNot ApplicableNot ApplicableNot Applicable
TajikistanRare indigenous cases.Very LowChloroquineP. vivax 90%
P. falciparum 10%
Mosquito avoidance only
TanzaniaAll areas at altitudes below 1,800 m (5,906 ft)ModerateChloroquineP. falciparum >85%
P. ovale >10%
P. malariae, and P. vivax rare
Atovaquone-proguanil, doxycycline, or mefloquine
ThailandPrimarily in provinces that border Burma (Myanmar), Cambodia, and Laos, and  the provinces of Kalasin, Krabi (Plai Phraya District), Nakhon Si Thammarat, Narathiwat, Pattani, Phang Nga (including Phang Nga City), Rayong, Sakon Nakhon, Songkhla, Surat Thani, and Yala, especially the rural forest and forest fringe areas of these provinces.  Rare to few cases in other parts of Thailand including the cities of Bangkok, Chang Mai, Chang Rai, Koh Phangan, Koh Samui, and Phuket.  None in the islands of Krabi Province (Koh Phi Phi, Koh Yao Noi, Koh Yao Yai, and Ko Lanta) and  Pattaya City.LowChloroquine and MefloquineP. falciparum 50% (up to 75% some areas)
P. vivax 50% (up to 60% some areas)
Remainder P. ovale

Provinces that border Burma (Myanmar), Cambodia, and Laos, the provinces of Kalasin, Krabi (Plai Phraya District only), Nakhon Si Thammarat, Narathiwat, Pattani, Phang Nga (including Phang Nga City), Rayong, Sakon Nakhon, Songkhla, Surat Thani, and Yala:

Atovaquone-proguanil or doxycycline

All other areas of Thailand including the cities of Bangkok, Chang Mai, Chang Rai, Koh Phangan, Koh Samui, and Phuket:

Mosquito avoidance only.

Timor-Leste (East Timor)AllNo dataChloroquineP. falciparum 50%
P. vivax 50%
P. ovale <1%
P. malariae <1%
Atovaquone-proguanil, doxycycline, or mefloquine
TogoAllHighChloroquineP. falciparum 85%
P. ovale 5-10%
Remainder P. vivax
Atovaquone-proguanil, doxycycline, or mefloquine
Tokelau (New Zealand)NoneNoneNot ApplicableNot ApplicableNot Applicable
TongaNoneNoneNot ApplicableNot ApplicableNot Applicable
Trinidad and TobagoNoneNoneNot ApplicableNot ApplicableNot Applicable
TunisiaNoneNoneNot ApplicableNot ApplicableNot Applicable
TurkeyRare indigenous cases in Mardin. None on the Incerlik US Air Force Base and on typical cruise itineraries.Very LowNoneP. vivax predominantly
P. falciparum sporadically
Mardin: Mosquito avoidance only
TurkmenistanNoneNoneNot ApplicableNot ApplicableNot Applicable
Turks and Caicos Islands (U.K.)NoneNoneNot ApplicableNot ApplicableNot Applicable
TuvaluNoneNoneNot 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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