Appendix 1: Malaria transmission and recommended preventive measures by geographical area

Afghanistan

Transmission occurs in all areas at elevations < 2500 m.

P. vivax
P. f.

Atovaquone-proguanil, doxycycline or mefloquine.

Albania

No malaria transmission.

n/a

None.

Algeria

No malaria transmission.

n/a

None.

American Samoa

No malaria transmission.

n/a

None.

Andorra

No malaria transmission.

n/a

None.

Angola

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Anguilla (UK)

No malaria transmission.

n/a

None.

Antigua and Barbuda

No malaria transmission.

n/a

None.

Argentina

No malaria transmission.

n/a

None.

Armenia

No malaria transmission.

n/a

None.

Aruba (NL)

No malaria transmission.

n/a

None.

Australia

No malaria transmission.

n/a

None.

Austria

No malaria transmission.

n/a

None.

Azerbaijan

Certified malaria-free in 2023.

n/a

None.

Bahamas

No malaria transmission.

n/a

None.

Bahrain

No malaria transmission.

n/a

None.

Bangladesh

No transmission in the city of Dhaka.

n/a

None.

Little to no transmission in areas of the country not described below.

P. f.
P. vivax*

PPM.

Transmission occurs in the Chattogram Division, including the Chittagong Hill Tract districts (Bandarban, Rangamati and Khagrachari), Cox's Bazaar, and the districts of Hobigonj, Kurigram, Moulvibazar, Mymensingh, Netrakona, Sherpur, Sunamgonj and Sylhet.

Atovaquone-proguanil, doxycycline or mefloquine.

Barbados

No malaria transmission.

n/a

None.

Belarus

No malaria transmission.

n/a

None.

Belgium

No malaria transmission.

n/a

None.

Belize

Certified malaria-free in 2023.

n/a

None.

Benin

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Bermuda (UK)

No malaria transmission.

n/a

None.

Bhutan

Low transmission in parts of the country, in rural areas <1700 m, and in districts along the southern border shared with India.

P. vivax
P. f.

PPM.

Bolivia (Plurinational State of)

No transmission in areas at elevations ≥ 2500 m.

n/a

None.

Transmission occurs in all areas at elevations < 2500 m. The risk is predominantly due to P. vivax, with exceptions listed below.

Transmission of P. f. occurs in the northern departments of Beni and Pando (especially in the localities of Guayaramerín, Riberalta, and Sena).

P. vivax
P. f.

Atovaquone-proguanil, doxycycline or mefloquine.

Bosnia and Herzegovina

No malaria transmission.

n/a

None.

Botswana

No transmission in the city of Gaborone, or in other areas not listed below.

n/a

None.

Low transmission in the districts of Kgalagadi North, Kweneng West, and Southern.

P. f.
P. vivax*

PPM.

Transmission occurs in the following districts/sub-districts: Central, Kweneng East, North-East (including Francistown), North-West (including Chobe National Park), and Okavango delta.

Atovaquone-proguanil, doxycycline or mefloquine.

Brazil

Some cases of P.vivax have been reported in 2018, in the town of Wenceslau Guimarães in Bahia State.

Little to no transmission in the states outside the administrative region of Amazonas, including Iguazu Falls, in the urban areas of Brasília, Recife, Rio de Janeiro, São Paulo, and Salvador.

Low transmission in the less forested areas in southern Mato Grosso, including most of the Pantanal.

P. vivax
P. f.

PPM.

There is residual transmission of P. vivax in the Atlantic Forest areas of the states of Espirito Santo, Minas Gerais, Rio de Janeiro, and São Paulo.

PPM.

Travellers spending extended periods in rural or forested areas may consider malaria chemoprophylaxis: atovaquone-proguanil, doxycycline or mefloquine.

Transmission occurs in most forested areas within the nine states of the Amazon region (Acre, Amapá, Amazonas, Maranhão [western part], Mato Grosso [northern part]), Pará [except Belém City], Rondônia, Roraima and Tocantins [western part]).

Transmission intensity varies from one municipality to another, and is higher in jungle mining areas, in agricultural settlements, in indigenous areas and in some peripheral urban areas of Cruzeiro do Sul, Manaus, Maraba, and Pôrto Velho.

Transmission also occurs on the periphery of large urban areas such as Boa Vista, Macapá, Rio Branco, and Santarém.

Atovaquone-proguanil, doxycycline or mefloquine.

British Virgin Islands (UK)

No malaria transmission.

n/a

None.

Brunei Darussalam

Human infection with P. knowlesi reported in forested areas.

n/a

PPM.

Travellers spending extended periods in rural or forested areas may consider chemoprophylaxis: atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Bulgaria

No malaria transmission.

n/a

None.

Burkina Faso

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Burundi

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Cabo Verde

Certified malaria-free in 2024.

n/a

None.

Cambodia

No transmission in the cities of Phnom Penh and Siem Reap.

n/a

None.

Low transmission in the tourist area of Angkor Wat and around Lake Tonlé Sap.

P. vivax
P. f.
P. knowlesi*

PPM.

Transmission occurs in all other areas not listed above.

P. falciparum resistance to mefloquine has been reported in western Cambodia and extends to the centre of the country.

For post-travel care, P. falciparum resistance to artesunate, lumefantrine, and piperaquine has been reported in western Cambodia and extends to the centre of the country. P. vivax resistance to chloroquine has been reported in eastern Cambodia.

Atovaquone-proguanil or doxycycline.

Cameroon

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Canada

No malaria transmission.

n/a

None.

Cayman Islands (UK)

No malaria transmission.

n/a

None.

Central African Republic

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Chad

All areas, except in the Sahara Desert.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Chile

No malaria transmission.

n/a

None.

China

Certified malaria-free in 2021.

n/a

None.

Colombia

No transmission in areas ≥ 1700 m, including Bogota, and in the urban areas of Baranquilla, Cartagena, and on the islands of San Andres and Providencia.

n/a

None.

Little to no transmission in northern rural areas and along the Caribbean coast.

P. f.
P. vivax

PPM.

Transmission occurs in rural and jungle areas <1700 m, and on excursions on the Magdalena River south of Baranquilla, on the Pacific coast, in the valleys of the Andes, and east of the Cordillera Oriental.

Atovaquone-proguanil, doxycycline or mefloquine.

Comoros

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Congo

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Congo, Democratic Republic of the (formerly Zaïre)

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Cook Islands (NZ)

No malaria transmission.

n/a

None.

Costa Rica

Little to no transmission in areas not listed below.

P. f.
P. vivax

PPM.

Transmission occurs in Alajuela Province near the border with Nicaragua and in Limón Province.

Atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Côte D'Ivoire (Ivory Coast)

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Croatia

No malaria transmission.

n/a

None.

Cuba

No malaria transmission.

n/a

None.

Curaçao (NL)

No malaria transmission.

n/a

None.

Cyprus

No malaria transmission.

n/a

None.

Czechia

No malaria transmission.

n/a

None.

Denmark

No malaria transmission.

n/a

None.

Djibouti

All areas.

P. f.
P. vivax

Atovaquone-proguanil, doxycycline or mefloquine.

Dominica

No malaria transmission.

n/a

None.

Dominican Republic

Little to no transmission through most of the country including resort areas.

Sporadic cases among travellers are possible given the very large travel volume to the Dominican Republic but generally does not warrant a change in approach to prevention.

P. f.

PPM.

Transmission occurs in the following provinces bordering Haiti: Dajabón, Elias Piña, and San Juan.

Atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Ecuador

Little to no transmission in the urban areas of Guayaquil or on the Galápagos Islands, and at elevations ≥ 1500 m, including Cuenca, Quito, and other urban areas and villages in the Andean highlands.

P. vivax
P. f.

PPM.

Transmission occurs in areas at elevations < 1500 m, including the provinces of Esmeraldas, Morona-Santiago, Orellana, Pastaza, Sucumbíos, and in the provinces of Carchi and Cotopaxi.

Atovaquone-proguanil, doxycycline or mefloquine.

Egypt

No malaria transmission.

n/a

None.

El Salvador

Certified malaria-free in 2021.

n/a

None.

Equatorial Guinea

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Eritrea

No transmission at elevations ≥ 2200 m, including the city of Asmara.

n/a

None.

Transmission occurs in all areas at elevations < 2200 m.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Estonia

No malaria transmission.

n/a

None.

Ethiopia

Little to no transmission at elevations ≥ 2500 m, and in the urban areas of Addis Ababa.

n/a

PPM.

Transmission occurs in all areas at elevations < 2500 m, including Axum (2139 m), Dire Dawa (1262 m), Harar (1848 m), and Nazret (1725 m).

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Fiji

No malaria transmission.

n/a

None.

Finland

No malaria transmission.

n/a

None.

France

No malaria transmission.

n/a

None.

French Guiana

No transmission in the city of Cayenne or on Devil's Island (Île du Diable).

n/a

None.

Low transmission along the coast but increasing towards the interior.

P. vivax
P. f.

PPM.

Travellers spending extended periods in rural or forested areas may consider chemoprophylaxis: atovaquone-proguanil, doxycycline or mefloquine.

Transmission occurs in all other areas, particularly along the rivers in the interior, in municipalities bordering Brazil (Oiapoque river valley) and Suriname (Maroni river valley); transmission also occurs in the communes of Kourou, Matoury, and Saint-Elie.

P. vivax
P. f.

Atovaquone-proguanil, doxycycline or mefloquine.

French Polynesia

No malaria transmission.

n/a

None.

Gabon

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Gambia

All areas.

P. f.

Atovaquone-proguanil, doxycycline or mefloquine.

Georgia

No malaria transmission.

n/a

None.

Germany

No malaria transmission.

n/a

None.

Ghana

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Gibraltar (UK)

No malaria transmission.

n/a

None.

Greece

Very limited local transmission associated with imported cases in agricultural areas.

No transmission in tourist areas.

P. vivax

None.

Greenland (Denmark)

No malaria transmission.

n/a

None.

Grenada

No malaria transmission.

n/a

None.

Guadeloupe (FR)

No malaria transmission.

n/a

None.

Guam (US)

No malaria transmission.

n/a

None.

Guatemala

No transmission in urban areas or areas at elevations > 1500 m.

No transmission in Guatemala City, Antigua, and Lake Atitlán.

n/a

None.

Low transmission in the departments of Chiquimula, Zacapa, Baja Verapaz, San Marcos, Jutiapa, Jalapa, El Progreso, Santa Rosa, Guatemala, Chimaltenango, Huehuetenango, and Quiche.

P. vivax
P. f.

PPM.

Transmission occurs in the departments of Escuintla (municipalities of Gomera, Masagua, Santa Lucia Cotzumalguapa, and Tiquisate), Alta Verapaz (municipalities of Telemán, Panzós, and La Tinta), Petén, Suchitepéquez, Retalhuleu, and Izabal.

Atovaquone-proguanil, chloroquine,
doxycycline or mefloquine.

Guinea

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Guinea-Bissau

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or
mefloquine.

Guyana

Little to no transmission in the cities of Amsterdam and Georgetown.

P. vivax
P. f.

PPM.

Transmission occurs in all other areas.

Atovaquone-proguanil, doxycycline or mefloquine.

Haiti

All areas.

P. f.

Atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Holy See (Vatican City)

No malaria transmission.

n/a

None.

Honduras

No transmission in the cities of Tegucigalpa and San Pedro Sula.

n/a

None.

Transmission occurs throughout the country, including the island of Roatán and other Bay Islands.

P. vivax
P. f.

Atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Hong Kong (China)

No malaria transmission.

n/a

None.

Hungary

No malaria transmission.

n/a

None.

Iceland

No malaria transmission.

n/a

None.

India

No transmission at elevations > 2000 m, and in parts of the states of Himachal Pradesh, Jammu and Kashmir, and Sikkim.

n/a

None.

Low transmission in the central urban areas of Delhi, Agra, Mumbai, Nagpur, Nasik, Pune, Kolkata, and Bangalore.

P. f.
P. vivax

PPM alone can be considered. If chemoprophylaxis is being considered: atovaquone-proguanil, doxycycline or mefloquine.

Transmission occurs in all other areas.

Transmission is relatively higher in the northeastern and central states, including Odisha, Chhattisgarh, Jharkhand, Madhya Pradesh, Maharashtra, and some north-eastern states such as Tripura, Meghalaya, and Mizoram.

Atovaquone-proguanil, doxycycline or mefloquine.

Indonesia

No transmission in the urban areas of Jakarta and Ubud, resort areas of Bali and Java, and Gili Islands and the Thousand Islands (Pulau Seribu).

n/a

None.

Low transmission in the rural areas of Java, including Pangandaran, Sukalumi, and Ujung Kulong.

P. f.
P. vivax
P. knowlesi*

PPM.

Transmission occurs in all areas of eastern Indonesia (provinces of Maluku, Maluku Utara, Nusa Tenggara Timur, Papua, and Papua Barat), including the town of Labuan Bajo and Komodo Islands in the Nusa Tenggara region.

Transmission also occurs in the rural areas of Kalimantan (Borneo), Nusa Tenggara Barat (including the island of Lombok), Sulawesi, and Sumatra.

Atovaquone-proguanil, doxycycline or mefloquine.

Iran, Islamic Republic of

Little to no transmission throughout most of the country.

n/a

PPM.

Recent outbreaks in Sistan and Baluchestan Province, along the border with Pakistan.

P. vivax
P. f.

Atovaquone-proguanil, doxycycline or mefloquine.

Iraq

No malaria transmission.

n/a

None.

Ireland

No malaria transmission.

n/a

None.

Israel

No malaria transmission.

n/a

None.

Italy

No malaria transmission.

n/a

None.

Jamaica

No malaria transmission.

n/a

None.

Japan

No malaria transmission.

n/a

None.

Jordan

No malaria transmission.

n/a

None.

Kazakhstan

No malaria transmission.

n/a

None.

Kenya

Little to no transmission at elevations ≥ 2500 m and in the urban areas of Nairobi.

P. f.
P. vivax*

PPM.

All other areas at elevations < 2500 m.

Atovaquone-proguanil, doxycycline or mefloquine.

Kiribati

No malaria transmission.

n/a

None.

Korea, Democratic People's Republic of (North Korea)

Little to no transmission in some southern areas.

P. vivax

PPM.

Korea, Republic of (South Korea)

Little to no transmission in the demilitarized zone (DMZ); rural areas in the northern parts of the provinces of Gyeonggi-do (Kyonggi) and Gangwon-do (Kangwon-do); and the northern part of the city of Incheon.

P. vivax

PPM.

Kosovo

No malaria transmission.

n/a

None.

Kuwait

No malaria transmission.

n/a

None.

Kyrgyzstan

No malaria transmission.

n/a

None.

Lao People's Democratic Republic (Laos)

No transmission in the city of Vientiane.

n/a

None.

Transmission occurs in the rest of the country predominantly due to P. f.

P. f.
P. vivax
P. knowlesi*

Atovaquone-proguanil, doxycycline or mefloquine.

Mefloquine resistance has been reported along the Laos-Myanmar border in the provinces of Bokeo and Louang Namtha, along the Laos-Thailand border in the province of Champasak and Saravan, along the Laos-Cambodia border, and along the Laos-Vietnam border.

Atovaquone-proguanil or doxycycline.

Latvia

No malaria transmission.

n/a

None.

Lebanon

No malaria transmission.

n/a

None.

Lesotho

No malaria transmission.

n/a

None.

Liberia

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Libya

No malaria transmission.

n/a

None.

Liechtenstein

No malaria transmission.

n/a

None.

Lithuania

No malaria transmission.

n/a

None.

Luxembourg

No malaria transmission.

n/a

None.

Macao (China)

No malaria transmission.

n/a

None.

Macedonia

No malaria transmission.

n/a

None.

Madagascar

Little to no transmission in the urban areas of Antananarivo.

P. f.
P. vivax*

PPM.

All other areas.

Atovaquone-proguanil, doxycycline or mefloquine.

Malawi

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Malaysia

No transmission in urban, suburban, and coastal areas.

n/a

None.

Transmission occurs in rural, forested areas.
Malaysia has reported zero indigenous non-zoonotic malaria cases since 2018. However, Malaysia is facing increasing cases of zoonotic malaria due to P. knowlesi. In 2021, 3575 cases were reported, resulting in 13 deaths.

P. knowlesi
P. vivax*

Atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Maldives

No malaria transmission.

n/a

None.

Mali

All areas, except in the Sahara Desert.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Malta

No malaria transmission.

n/a

None.

Marshall Islands

No malaria transmission.

n/a

None.

Martinique (FR)

No malaria transmission.

n/a

None.

Mauritania

No transmission in the northern provinces of Dakhlet-Nouadhibou, Tiris-Zemmour, and in the Sahara Desert.

n/a

None.

Transmission occurs in southern provinces, including Nouakchott.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Mauritius

No malaria transmission.

n/a

None.

Mayotte (FR)

Little to no transmission in all areas. Mayotte is transitioning into an elimination phase.

P. f.
P. vivax*

PPM.

Mexico

Little to no transmission in Campeche, Durango, Nayarit, Quintana Roo, Sinaloa, Sonora, and Tabasco.

Recent small outbreak in Oaxaca.

No malaria along the United States-Mexico border.

P. vivax

PPM.

Low but possibly increasing transmission in Chiapas and the southern part of Chihuahua.

Atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Micronesia, Federated States of

No malaria transmission.

n/a

None.

Moldova, Republic of

No malaria transmission.

n/a

None.

Monaco

No malaria transmission.

n/a

None.

Mongolia

No malaria transmission.

n/a

None.

Montenegro

No malaria transmission.

n/a

None.

Montserrat (UK)

No malaria transmission.

n/a

None.

Morocco

No malaria transmission.

n/a

None.

Mozambique

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Myanmar

No transmission at elevations ≥ 1000 m or in urban areas.

n/a

None.

Transmission occurs in areas at elevations < 1000 m, including Bagan, but not in urban areas.

Human infection with P. knowlesi reported.

P. vivax
P.f.*

Atovaquone–proguanil, doxycycline or mefloquine.

Mefloquine resistance has been reported in Kayin state and the eastern part of Shan state.

For post-travel care, emerging artemisinin resistance is suspected in south-eastern Myanmar. P. vivax resistance to chloroquine has been reported.

Atovaquone-proguanil or doxycycline.

Namibia

No transmission in the southern two-thirds of the country, including the city of Windhoek.

n/a

None.

Transmission occurs in the regions of Kunene (including Etosha National park), Kavango (East and West), Ohangwena, Omaheke, Omusati, Oshana, Oshikoto, Otjozondjupa, and Zambezi.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Nauru

No malaria transmission.

n/a

None.

Nepal

No transmission in Kathmandu, Pokhara, typical Himalayan treks, and all other areas not listed below.

n/a

None.

Year-round transmission occurs at altitudes < 2000 m and in rural areas of the 20 Terai districts bordering India, with occasional seasonal outbreaks of P. f.

Seasonal transmission of P. vivax takes place in 45 districts of the inner Terai and mid-hills.

P. vivax
P. f.*

Atovaquone-proguanil, doxycycline or mefloquine.

Netherlands

No malaria transmission.

n/a

None.

New Caledonia (FR)

No malaria transmission.

n/a

None.

New Zealand

No malaria transmission.

n/a

None.

Nicaragua

Little to no transmission in Boaco, Chinandega, Esteli, Jinotega, Leon, Matagalpa, Nueva Segovia, and Managua, and in departments not listed below.

P. vivax
P. f

PPM.

Transmission occurs in Región Autónoma Atlántico Norte (RAAN), and Región Autónoma Atlántico Sur (RAAS).

Atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Niger

All areas, except in the Sahara Desert.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Nigeria

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Niue (NZ)

No malaria transmission.

n/a

None.

Northern Mariana Islands (US)

No malaria transmission.

n/a

None.

Norway

No malaria transmission.

n/a

None.

Oman

Sporadic transmission of P. f. and P. vivax may occur subsequent to imported cases.

n/a

None.

Pakistan

Transmission occurs in all areas, including urban areas < 2500 m.

P. vivax
P. f.

Atovaquone-proguanil, doxycycline or mefloquine.

Palau

No malaria transmission.

n/a

None.

Panama

Little to no transmission in Panama City, the Canal zone, or regions not listed below.

P. vivax
P. f.

PPM.

Low transmission in Ngäbe Buglé,Bocas del Toro, Chiriqui, Colon, and Veraguas on the west side of the canal.

PPM.

Travellers spending extended periods in this area may consider malaria chemoprophylaxis: atovaquone-proguanil, chloroquine, doxycycline or mefloquine.

Most of the transmission occurs in provinces east of the Panama Canal towards the border with Colombia, where P. f. resistance to chloroquine has been reported.

Atovaquone-proguanil, doxycycline or mefloquine.

Papua New Guinea

All areas at elevations < 2000 m.

P. vivax
P.f.

Atovaquone-proguanil, doxycycline or mefloquine.

Paraguay

None.

n/a

None.

Peru

No transmission at elevations ≥ 2500 m, including the highland tourist areas (Machu Picchu, Lake Titicaca, and the urban areas of Arequipa, Cuzco, Puno), along the Pacific Coast of Lima Province. No transmission in the cities of Moquegua, Ica, Nazca, and Tacna.

n/a

None.

All areas < 2500 m (except areas listed above). This includes the urban areas of Puerto Maldonado and Iquitos.

Most P.f. cases occur in the region of Loreto.

P. vivax
P. f.

Atovaquone-proguanil, doxycycline or mefloquine.

Philippines

No transmission in Manila and other urban areas.

P. f.
P. vivax
P. knowlesi

None.

Transmission occurs in Palawan and Mindanao Islands.

Atovaquone-proguanil, doxycycline or mefloquine.

Pitcairn Islands (UK)

No malaria transmission.

n/a

None.

Poland

No malaria transmission.

n/a

None.

Portugal

No malaria transmission.

n/a

None.

Puerto Rico (US)

No malaria transmission.

n/a

None.

Qatar

No malaria transmission.

n/a

None.

Réunion (FR)

No malaria transmission.

n/a

None.

Romania

No malaria transmission.

n/a

None.

Russian Federation (Russia)

No malaria transmission.

n/a

None.

Rwanda

All areas.

P.f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Saint-Barthélemy (FR)

No malaria transmission.

n/a

None.

Saint Helena (UK)

No malaria transmission.

n/a

None.

Saint Kitts and Nevis

No malaria transmission.

n/a

None.

Saint Lucia

No malaria transmission.

n/a

None.

Saint Martin (FR)

No malaria transmission.

n/a

None.

Saint Pierre and Miquelon (FR)

No malaria transmission.

n/a

None.

Saint Vincent and the Grenadines

No malaria transmission.

n/a

None.

Samoa

No malaria transmission.

n/a

None.

San Marino

No malaria transmission.

n/a

None.

São Tomé and Príncipe

All areas.

P.f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Saudi Arabia

No transmission through most of the country.

n/a

None.

Transmission occurs in Asir and Jazan emirates by the border with Yemen.

P. f.
P. vivax

Atovaquone-proguanil, doxycycline or mefloquine.

Senegal

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Serbia

No malaria transmission.

n/a

None.

Seychelles

No malaria transmission.

n/a

None.

Sierra Leone

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Singapore

No malaria transmission.

n/a

None.

Saint Maarten (NL)

No malaria transmission.

n/a

None.

Slovakia

No malaria transmission.

n/a

None.

Slovenia

No malaria transmission.

n/a

None.

Solomon Islands

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Somalia

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

South Africa

No transmission in most of the country, including the Garden Route and major urban areas.

n/a

None.

Transmission occurs along the border with Zimbabwe and Mozambique.

Specifically in Mopani, Vhembe, Greater Sekhukhune, Capricorn and Waterberg district municipalities of Limpopo Province; Ehlanzeni district municipality in Mpumalanga Province; and uMkhanyakude, Zululand and King Cetshwayo district municipalities in Kwazulu-Natal Province.

Present in Kruger National Park.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

South Sudan

All areas, except in the Sahara Desert.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Spain

No malaria transmission.

n/a

None.

Sri Lanka

No malaria transmission.

n/a

None.

Sudan, Republic of

All areas, except in the Sahara Desert.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Suriname

Little to no transmission through most of the country.

P. f.
P. vivax

PPM.

Transmission occurs in the Tapanahony municipality in Sipaliwini Province.

For post-travel care, some decline in quinine sensitivity has been reported.

Atovaquone-proguanil, doxycycline or mefloquine.

Swaziland (Eswatini)

Little to no transmission through most of the country.

P. f.
P. vivax*

PPM.

Transmission occurs in eastern areas bordering Mozambique and South Africa, including all of Lubombo district and the eastern half of Hhohho, Manzini, and Shiselweni districts.

Atovaquone-proguanil, doxycycline or mefloquine.

Sweden

No malaria transmission.

n/a

None.

Switzerland

No malaria transmission.

n/a

None.

Syrian Arab Republic (Syria)

No malaria transmission.

n/a

None.

Tajikistan

Certified malaria-free in 2023.

n/a

None.

Tanzania, United Republic of

Transmission occurs in all areas at elevations < 1800 m, including Zanzibar.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Thailand

Little to no transmission in other parts of the country not listed below, including the provinces of Chiang Mai and Chiang Rai, and the islands of Koh Pha Ngan, Koh Samui, and Phuket.

n/a

PPM.

Transmission occurs in the provinces that border Myanmar, Cambodia, and Malaysia.

Transmission also occurs in the Ubon Ratchathani and Phitsanulok Provinces (on the border with Laos), and the Surat Thani Province.

There is resistance to mefloquine.

For post-travel care, P. falciparum resistance to artemisinin has been reported near the border with Cambodia, and resistance to quinine near the borders with Cambodia and Myanmar. P. vivax resistance to chloroquine has been reported.

P. vivax
P. f.
P. knowlesi*

Atovaquone-proguanil or doxycycline.

Timor-Leste (East Timor)

Little to no transmission through much of country.

P. f.
P. vivax*

PPM.

Togo

All areas.

P. f
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Tokelau (NZ)

No malaria transmission.

n/a

None.

Tonga

No malaria transmission.

n/a

None.

Trinidad and Tobago

No malaria transmission.

n/a

None.

Tunisia

No malaria transmission.

n/a

None.

Türkiye

No malaria transmission.

n/a

None.

Turkmenistan

No malaria transmission.

n/a

None.

Turks and Caicos Islands (UK)

No malaria transmission.

n/a

None.

Tuvalu

No malaria transmission.

n/a

None.

Uganda

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Ukraine

No malaria transmission.

n/a

None.

United Arab Emirates

No malaria transmission.

n/a

None.

United Kingdom

No malaria transmission.

n/a

None.

United States

No malaria transmission.

n/a

None.

US Virgin Islands

No malaria transmission.

n/a

None.

Uruguay

No malaria transmission.

n/a

None.

Uzbekistan

No malaria transmission.

n/a

None.

Vanuatu

All areas.

P. vivax
P. f.*

Atovaquone-proguanil, doxycycline or mefloquine.

Venezuela, Bolivarian Republic of

Transmission occurs in all areas <1700 m.
Present in Angel Falls.

P. vivax
P. f.

Atovaquone-proguanil, doxycycline or mefloquine.

Vietnam

No transmission in Da Nang, Haiphong, Hanoi, Ho Chi Minh City (Saigon), NhaTrang, and Qui Nhon.

n/a

None.

Little to no transmission in the Red River Delta and the Mekong Delta.

The common coastal itinerary between Ho Chi Minh City and Hanoi with overnights mainly in urban areas does not typically require chemoprophylaxis.

P. f.
P. vivax
P. knowlesi

PPM.

Transmission occurs in rural areas (except where there is resistance to mefloquine, see below).

Atovaquone-proguanil, doxycycline or mefloquine.

Transmission occurs in the rural areas of Dac Lac, Gia Lai, Khanh Hoa, Kon Tum, Lam Dong, Ninh Thuan, Song Be, and Tay Ninh.

There is resistance to mefloquine.

Atovaquone-proguanil or doxycycline.

West Bank and Gaza Strip

No malaria transmission.

n/a

None.

Western Sahara

Malaria transmission very rare. Unknown.

Unknown

PPM.

Yemen

No transmission at elevations > 2000 m, including in the city of Sana'a.

n/a

None.

Little to no transmission on Socotra Island.

P. f.
P. vivax*

PPM.

Transmission occurs in all areas at elevations < 2000 m, except Socotra Island.

Atovaquone-proguanil, doxycycline or mefloquine.

Zambia

All areas.

P. f.
P. vivax*

Atovaquone-proguanil, doxycycline or mefloquine.

Zimbabwe

Low transmission in Harare and Bulawayo, and areas ≥ 1200 m.

P. f.
P. vivax*

PPM.

Atovaquone-proguanil, doxycycline or mefloquine.

Transmission occurs in all areas at elevations < 1200 m.