Malaria Information and Prophylaxis, by Country [S]
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 Travelers2 | Drug Resistance3 | Malaria Species4 | Recommended Chemoprophylaxis5 | Key Information Needed and Helpful Links to Assess Need for Prophylaxis for Select Countries |
|---|---|---|---|---|---|---|
| Saint Helena (U.K.) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Saint Kitts (Saint Christopher) and Nevis (U.K.) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Saint Lucia | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Saint Pierre and Miquelon (France) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Saint Vincent and the Grenadines | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Samoa (formerly Western Samoa) | None | None | Not Applicable | Not Applicable | Not Applicable | |
| San Marino | None | None | Not Applicable | Not Applicable | Not Applicable | |
| São Tomé and Príncipe | All | Very Low | Chloroquine |
P. falciparum 85%, P. malariae, P. ovale, and P. vivax 15% combined |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Saudi Arabia | Rare cases in Asir and Jazan emirates by border with Yemen. None in the cities of Jeddah, Mecca, Medina, Riyadh, and Ta’if. | Very Low | Chloroquine |
P. falciparum predominantly Remainder P. vivax |
Mosquito avoidance only | 1) City(ies) of travel 2) Emirate(s) of travel To determine if a city is within a certain emirateExternal Map of regions of Saudi ArabiaExternal |
| Senegal | All | High | Chloroquine |
P. falciparum >85% P. ovale 5-10% P. vivax rare |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Serbia | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Seychelles | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Sierra Leone | All | High | Chloroquine |
P. falciparum >85% P. ovale 5%-10%, P. malariae and P. vivax rare |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Singapore | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Slovakia | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Slovenia | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Solomon Islands | All | High | Chloroquine |
P. falciparum 60% P. vivax 35-40% P. ovale <1% |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Somalia | All | High | Chloroquine |
P. falciparum 90% P. vivax 5%-10% P. malariae, and P. ovale rare |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| South Africa | Present along the border with Zimbabwe and Mozambique. Specifically in Mopani, Vhembe, and Waterberg district municipalities of Limpopo Province; Ehlanzeni district municipality in Mpumalanga Province; and Umknanyakude in Kwazulu-Natal Province. Present in Kruger National Park. | Low | Chloroquine |
P. falciparum 90% P. vivax 5% P. ovale 5% |
Areas in Limpopo, Mpumalanga, and Kwazulu-Natal Provinces with malaria: Atovaquone-proguanil, doxycycline, or mefloquine |
Province(s) of travel
Provinces of South Africa to determine if a city is within a certain provinceExternal |
| South Georgia and the South Sandwich Islands | None | None | Not Applicable | Not Applicable | Not Applicable | |
| South Korea | Limited 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). | Low | None | P. vivax 100% | Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine7
|
Provinces(s) of travel Administrative divisions of South KoreaExternal |
| South Sudan, Republic of | All | High | Chloroquine |
P. falciparum 90%, P.vivax 5%–10%, P. malariae and P. ovale rare. |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Spain | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Sri Lanka | None | None | Not applicable | Not applicable | Not applicable | |
| Sudan | All | High | Chloroquine |
P. falciparum 90%, P.vivax 5%–10%, P. malariae and P. ovale rare. |
Atovaquone-proguanil, doxycycline, or mefloquine | |
| Suriname | Present in the municipality of Tapanahony in Sipaliwini Province. Rare cases Brokopondo Province, and Boven Saramacca municipality in Sipaliwini Province. No malaria in Paramaribo. | Low | Chloroquine |
P. falciparum 70% P. vivax 15-20% |
Tapanahony municipality in Sipaliwini Province: Atovaquone-proguanil, doxycycline, or mefloquine Other areas with malaria: Mosquito avoidance only |
Province(s) of travel
Map provinces of Suriname to determine if a city is within a certain provinceExternal |
| Swaziland | Present in eastern areas bordering Mozambique and South Africa, including all of Lubombo district and the eastern half of Hhohho, Manzini, and Shiselweni districts. | Very Low | Chloroquine |
P. falciparum 99% P. ovale and P. vivax 1% |
Atovaquone-proguanil, doxycycline, or mefloquine | District(s) of travel
Districts of Swaziland to determine if a city is within a certain districtExternal |
| Sweden | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Switzerland | None | None | Not Applicable | Not Applicable | Not Applicable | |
| Syria | 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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