Malaria Information and Prophylaxis, by Country [M]
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 Travelers2 | Drug Resistance3 | Malaria Species4 | Recommended Chemoprophylaxis5 | Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries |
|---|---|---|---|---|---|---|
| Macau SAR (China) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Macedonia | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Madagascar | All areas, except rare cases in Antananarivo. | Moderate | Chloroquine |
P. falciparum 85% P. vivax 5-10% P. ovale 5% |
All areas except Antananarivo: Atovaquone-proguanil, doxycycline, or mefloquine
Antananarivo: Mosquito avoidance only. |
|
| Madeira Islands (Portugal) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Malawi | All | Moderate | Chloroquine |
P. falciparum 90% P. malariae, P. ovale, and P. vivax 10% combined |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Malaysia | Present in rural areas. None in Georgetown, Kuala Lampur, and Penang State (includes Penang Island). | Low | Chloroquine |
P. falciparum P. vivax P. malariae, P. knowlesi, and P. ovale. |
Rural areas: Atovaquone-proguanil, doxycycline, or mefloquine | 1) City(ies) of travel 2) Province(s) of travelMap of states of Malaysia to determine if a city is within a certain stateExternal |
| Maldives | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Mali | All | High | Chloroquine |
P. falciparum >85% P. ovale 5-10% P. vivax rare |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Malta | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Marshall Islands | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Martinique (France) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Mauritania | All areas including the city of Nouakchott. | High | Chloroquine |
P. falciparum >85% P. ovale 5-10% P. vivax rare |
Atovaquone-proguanil, doxycycline, or mefloquine | 1) City(ies) of travel 2) Province(s) of travelMap of regions in Mauritania to determine if a city is within a certain regionExternal |
| Mauritius | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Mayotte (France) | Rare cases | No data | Chloroquine |
P. falciparum 93%, P. vivax 5%, P. malariae and P. ovale 2% |
Mosquito avoidance only | |
| Mexico | Present in Campeche, Chiapas, Chihuahua, Nayarit, and Sinaloa. Rare cases in Durango, Jalisco, Oaxaca, Sonora, and Tabasco. Rare cases in the municipality of Othon P. Blanco in the southern part of Quintana Roo bordering Belize. No malaria along the United States-Mexico border. | Very Low | None | P. vivax 100% | States of Campeche, Chiapas, Chihuahua, Nayarit, and Sinaloa: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7 . States of Durango, Jalisco, Oaxaca, Sonora, Tabasco, and Othon P. Blanco municipality of Quintana Roo: Mosquito avoidance only.
|
State(s) of travel
Map of states of Mexico to determine if a city is within a certain stateExternal |
| Micronesia, Federated States of; Includes: Yap Islands, Pohnpei, Chuuk, and Kosrae | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Moldova | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Monaco | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Mongolia | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Montenegro | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Montserrat (U.K.) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Morocco | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Mozambique | All | Moderate | Chloroquine |
P. falciparum >90% P. malariae, P. ovale, and P. vivax rare |
Atovaquone-proguanil, doxycycline, or mefloquine |
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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