Malaria Information and Prophylaxis, by Country [T]
The information presented in this table is consistent 1 with the information in the CDC Health Information for International Travel (the “Yellow Book,” New for 2018). 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|
|Taiwan||None||None||Not Applicable||Not Applicable||Not Applicable|
|Tajikistan||Rare indigenous cases.||Very Low||Chloroquine||P. vivax 90%
P. falciparum 10%
|Mosquito avoidance only|
|Tanzania||All areas at altitudes below 1,800 m (5,906 ft)||High||Chloroquine||P. falciparum >85%
P. ovale >10%
P. malariae, and P. vivax rare
|Atovaquone-proguanil, doxycycline, or mefloquine||Altitude of city(ies) of travel|
|Thailand||Primarily 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.||Low||Chloroquine and Mefloquine||P. falciparum 50% (up to 75% some areas)
P. vivax 50% (up to 60% some areas)
P. ovale and P. knowlesi rare.
|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.
|Map of provinces of Thailand to determine if a city is within a certain district
|Timor-Leste (East Timor)||All||Moderate||Chloroquine||P. falciparum 50%
P. vivax 50%
P. ovale <1%
P. malariae <1%
|Atovaquone-proguanil, doxycycline, or mefloquine|
|Togo||All||High||Chloroquine||P. falciparum 85%
P. ovale 5-10%
Remainder P. vivax
|Atovaquone-proguanil, doxycycline, or mefloquine|
|Tokelau (New Zealand)||None||None||Not Applicable||Not Applicable||Not Applicable|
|Tonga||None||None||Not Applicable||Not Applicable||Not Applicable|
|Trinidad and Tobago||None||None||Not Applicable||Not Applicable||Not Applicable|
|Tunisia||None||None||Not Applicable||Not Applicable||Not Applicable|
|Turkey||None||None||Not Applicable||Not Applicable||Not Applicable|
|Turkmenistan||None||None||Not Applicable||Not Applicable||Not Applicable|
|Turks and Caicos Islands (U.K.)||None||None||Not Applicable||Not Applicable||Not Applicable|
|Tuvalu||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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