Malaria Information and Prophylaxis, by Country [C]
The information presented in this table is consistent 1 with the information in the CDC Health Information for International Travel (the “Yellow Book”).
In July 2018, tafenoquine (ArakodaTM) was approved by the FDA for prevention of malaria. When available in the US, tafenoquine will be another option for prevention of malaria in adults with normal G6PD status in all areas where chemoprophylaxis is recommended.
| Country | Areas with Malaria | Estimated Relative Risk of Malaria for US Travelers 2 | Drug Resistance3 | Malaria Species4 | Recommended Chemoprophylaxis5 | Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries |
|---|---|---|---|---|---|---|
| Cambodia | Present throughout the country including Siem Reap city. None in the city of Phnom Penh and the temple complex at Angkor Wat. | Low | Chloroquine
Mefloquine |
P. falciparum 86%
P. vivax 12% P. malariae 2%, P. knowlesi rare |
In the provinces of Banteay Meanchey, Battambang, Kampot, Koh Kong, Odder Meanchey, Pailin, Preah Vihear, Pursat, and Siem Reap bordering Thailand: Atovaquone-proguanil or doxycycline
All other areas with malaria: Atovaquone-proguanil, doxycycline, or mefloquine |
1) City(ies) of travel 2) Province(s) of travel
Map of provinces of CambodiaExternal
|
| Cameroon | All | High | Chloroquine |
P. falciparum >85%
P. ovale 5-10% P. vivax rare |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Canada | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Canary Islands (Spain) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Cape Verde | Limited cases on Sao Tiago (also known as Santiago) Island. | Very Low | Chloroquine | PrimarilyP. falciparum | Mosquito avoidance only | Island of Travel Map of Cape VerdeExternal |
| Cayman Islands (U.K.) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Central African Republic | All | High | Chloroquine |
P. falciparum 85%
P. malariae, P. ovale, and P. vivax 15% combined |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Chad | All | High | Chloroquine |
P. falciparum 85%
P. malariae, P. ovale, and P. vivax 15% combined |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Chile | None | None | Not Applicable | Not Applicable | Not Applicable | |
| China | Present in the counties along the China-Burma (Myanmar) border in Yunnan Province. Limited transmission in Motuo county in Tibet. No malaria in areas where most major river cruises pass. | Very Low | Chloroquine
Mefloquine |
Primarily P. vivax
P. falciparum in Yunnan Province only. |
Along China-Burma (Myanmar) border in the western part of Yunnan province: Atovaquone-proguanil or doxycycline. Motuo county in Tibet: Mosquito avoidance only. | 1) Month(s) of travel
2) City(ies) of travel 3) Province(s) of travel 4) Altitude of city(ies) of travel
Altitude information and to determine if a city is within a certain provinceExternal |
| Christmas Island (Australia) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Cocos (Keeling) Islands (Australia) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Colombia | All areas at altitudes below 1,700 m (5,577 ft). None in Bogota, Cartagena, and Medellin. | Low | Chloroquine |
P. falciparum 50%
P. vivax 50% |
Atovaquone-proguanil, doxycycline, or mefloquine | 1) City(ies) of travel
2) Altitude of city(ies) of travel Altitude informationExternal for Colombia |
| Comoros | All | No data | Chloroquine | Primarily P. falciparum | Atovaquone-proguanil, doxycycline, or mefloquine | |
| Congo, Republic of the (Congo-Brazzaville) | All | High | Chloroquine |
P. falciparum 90%
P. ovale 5-10% P. vivax rare |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Cook Islands (New Zealand) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Costa Rica | Last outbreak reported March through December 2017 in Matina Canton in Limon Province, Sarapiqui Canton in Heredia Province, and San Carlos Canton in Alajuela Province. [Report of malaria in traveler to Costa Rica posted on May 10, 2018 has been rescinded. The traveler did not have malaria. More information here.] | Very Low | None | Primarily P. vivax historically | Mosquito avoidance only | |
| Côte d’Ivoire | All | High | Chloroquine |
P. falciparum 85%
P. ovale 5-10% P. vivax rare |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Croatia | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Cuba | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Cyprus | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Czech Republic | None | None | Not Applicable | Not Applicable | Not Applicable |
1. Factors that affect local malaria transmission patterns can change rapidly and from year to year, such as local weather conditions, mosquito vector density, and prevalence of infection. Information in these tables is updated regularly.
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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