Malaria Information and Prophylaxis, by Country [G]

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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.

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Malaria Information and Prophylaxis by Country
Country Areas with Malaria Estimated Relative Risk of Malaria for US Travelers2 Drug Resistance3 Malaria Species4 Recommended Chemoprophylaxis5 Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries
Gabon All High Chloroquine P. falciparum 90%
P. malariae, P. ovale, P. vivax 10% combined 		Atovaquone-proguanil, doxycycline, or mefloquine
Gambia, The All High Chloroquine P. falciparum ≥ 85%
P. ovale 5%-10%
P. malariae, P. vivax rare		 Atovaquone-proguanil, doxycycline, or mefloquine
Georgia None None Not Applicable Not Applicable Not Applicable
Germany None None Not Applicable Not Applicable Not Applicable
Ghana All High Chloroquine P. falciparum 90%
P. ovale 5-10%
P. vivax rare		 Atovaquone-proguanil, doxycycline, or mefloquine
Gibraltar (U.K.) None None Not Applicable Not Applicable Not Applicable
Greece Rare focal transmission May-Nov associated with imported malaria cases in agricultural areas. None in tourist areas None Not Applicable P. vivax 100% None
Greenland (Denmark) None None Not Applicable Not Applicable Not Applicable
Grenada None None Not Applicable Not Applicable Not Applicable
Guadeloupe, including St. Barthélemy and Saint Martin (France) None None Not Applicable Not Applicable Not Applicable
Guam (U.S.) None None Not Applicable Not Applicable Not Applicable
Guatemala Rural areas only at altitudes below 1,500 m (4,921 ft).  None in Antigua, Guatemala City, or Lake Atitlán Low None P. vivax 97%
P. falciparum 3%		 Escuintla Province: Atovaquone-proguanil, chloroqouine, doxycycline, or mefloquine

All other areas with malaria: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7

1) City(ies) of travel
2) Province(s) of travel
3) Altitude of city(ies) of travel
To determine if a city is within a certain provinceExternal
Provinces of GuatemalaExternal
Altitude informationExternal
Guinea All High Chloroquine P. falciparum >85%
P. ovale 5-10%
P. vivax rare		 Atovaquone-proguanil, doxycycline, or mefloquine
Guinea-Bissau All Moderate Chloroquine P. falciparum >85%
P. ovale 5-10%
P. vivax rare		 Atovaquone-proguanil, doxycycline, or mefloquine
Guyana All areas below 900m (2,953ft)
Rare cases in the cities of Amsterdam and Georgetown		 High Chloroquine P. falciparum 50%
P. vivax 50%		 Areas with malaria except the cities of Amsterdam and Georgetown: Atovaquone-proguanil, doxycycline, or mefloquine.
Cities of Amsterdam and Georgetown: Mosquito avoidance only.		 1) City(ies) of travel
2) Altitude of city(ies) of travel
Altitude informationExternal for Guyana
Map of GuyanaExternal

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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Page last reviewed: November 8, 2018
Content source: Global Health, Division of Parasitic Diseases and Malaria